Provider Demographics
NPI:1689948440
Name:EVANS, ELIZABETH SEBRANEK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SEBRANEK
Last Name:EVANS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:SEBRANEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10920 RIVER FRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3538
Mailing Address - Country:US
Mailing Address - Phone:801-878-1091
Mailing Address - Fax:
Practice Address - Street 1:10920 RIVER FRONT PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-3538
Practice Address - Country:US
Practice Address - Phone:801-878-1091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-25
Last Update Date:2012-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7130013-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy