Provider Demographics
NPI:1154756864
Name:EVANS, MONICA E (PHARMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:E
Last Name:EVANS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25637 CONIFER RD
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9078
Mailing Address - Country:US
Mailing Address - Phone:303-816-4970
Mailing Address - Fax:
Practice Address - Street 1:25637 CONIFER RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9078
Practice Address - Country:US
Practice Address - Phone:303-816-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0019527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist