Provider Demographics
NPI:1881188894
Name:EVANS, JULIE TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:TAYLOR
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 1:123 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-6197
Mailing Address - Country:US
Mailing Address - Phone:910-874-6098
Mailing Address - Fax:
Practice Address - Street 1:1347 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9548
Practice Address - Country:US
Practice Address - Phone:910-862-8517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist