Provider Demographics
NPI:1699484832
Name:EVERS, MARISSA KAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:KAY
Last Name:EVERS
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 1:625 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-1247
Mailing Address - Country:US
Mailing Address - Phone:641-895-6750
Mailing Address - Fax:
Practice Address - Street 1:510 E JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1812
Practice Address - Country:US
Practice Address - Phone:641-872-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist