Provider Demographics
NPI:1295571255
Name:ANGE, EVETTE CARAWAY (RPH)
Entity type:Individual
Prefix:MRS
First Name:EVETTE
Middle Name:CARAWAY
Last Name:ANGE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-5393
Mailing Address - Country:US
Mailing Address - Phone:337-433-4692
Mailing Address - Fax:
Practice Address - Street 1:820 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:LA
Practice Address - Zip Code:70669-5393
Practice Address - Country:US
Practice Address - Phone:337-433-4692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist