Provider Demographics
NPI:1326362757
Name:EVANS, THERESA M (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9154 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-4392
Mailing Address - Country:US
Mailing Address - Phone:412-818-8906
Mailing Address - Fax:
Practice Address - Street 1:2775 MOSSIDE BLVD
Practice Address - Street 2:1ST FLOOR, MAIN LOBBY
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-357-7479
Practice Address - Fax:855-689-0140
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP440230OtherSTATE LICENSE