Provider Demographics
NPI:1063547081
Name:EVANS, SHEILA L (CPHT)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:L
Last Name:EVANS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:1633 LAKEWAY RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1955
Mailing Address - Country:US
Mailing Address - Phone:423-317-0534
Mailing Address - Fax:
Practice Address - Street 1:1224 GAY STREET
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725
Practice Address - Country:US
Practice Address - Phone:865-397-3444
Practice Address - Fax:865-397-6279
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26871183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician