Provider Demographics
NPI:1558877563
Name:EVANS, CARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
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 1:8200 42ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1100
Mailing Address - Country:US
Mailing Address - Phone:763-531-7462
Mailing Address - Fax:763-535-5987
Practice Address - Street 1:8200 42ND AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1100
Practice Address - Country:US
Practice Address - Phone:763-531-7462
Practice Address - Fax:763-535-5987
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21430183500000X
MN122386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist