Provider Demographics
NPI:1477149672
Name:EVENS, ANDREW ROBERT (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:EVENS
Suffix:
Gender:M
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:N85W15882 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3082
Mailing Address - Country:US
Mailing Address - Phone:262-437-0031
Mailing Address - Fax:262-255-2058
Practice Address - Street 1:N85W15882 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3082
Practice Address - Country:US
Practice Address - Phone:262-437-0031
Practice Address - Fax:262-255-2058
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18583-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist