Provider Demographics
NPI:1780721571
Name:EVANS, CANDIE SUE MARCHAND (PA-C)
Entity type:Individual
Prefix:MISS
First Name:CANDIE
Middle Name:SUE MARCHAND
Last Name:EVANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CANDIE
Other - Middle Name:S
Other - Last Name:MARCHAND-EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:6011 E WOODMEN RD STE 360
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2606
Practice Address - Country:US
Practice Address - Phone:719-571-8550
Practice Address - Fax:719-571-8555
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002822363AS0400X
COPA.0005784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant