Provider Demographics
NPI:1497033096
Name:EVENSON, LINDA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ELIZABETH
Last Name:EVENSON
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 1:1850 ADAMS ST
Mailing Address - Street 2:T-0663
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4864
Mailing Address - Country:US
Mailing Address - Phone:507-625-9009
Mailing Address - Fax:507-625-9009
Practice Address - Street 1:1850 ADAMS ST
Practice Address - Street 2:T-0663
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4864
Practice Address - Country:US
Practice Address - Phone:507-625-9009
Practice Address - Fax:507-625-9009
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-30
Last Update Date:2011-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist