Provider Demographics
NPI:1982698650
Name:EVINK, MICHELE MARIE (MS, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MARIE
Last Name:EVINK
Suffix:
Gender:F
Credentials:MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-0443
Mailing Address - Country:US
Mailing Address - Phone:641-342-3611
Mailing Address - Fax:641-342-5429
Practice Address - Street 1:800 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1619
Practice Address - Country:US
Practice Address - Phone:641-342-5322
Practice Address - Fax:641-342-5429
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist