NPI | 1538331921 |
---|---|
Former Name | CASEY LYNN EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA150161) |
363A00000X Physician Assistant (Licence: WA PA60371391) | |
363AM0700X Physician Assistant, Medical (Licence: ID PA-2000) | |
363AS0400X Physician Assistant, Surgical (Licence: ID PA-2000) | |
Enumeration Date | 2008-03-26 |
Last Update Date | 2021-05-03 |