Provider Demographics
NPI:1801171244
Name:EVANS, SARAH ALLISON (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALLISON
Last Name:EVANS
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 W EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8988
Mailing Address - Country:US
Mailing Address - Phone:208-713-3528
Mailing Address - Fax:208-378-1322
Practice Address - Street 1:10302 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8988
Practice Address - Country:US
Practice Address - Phone:208-713-3528
Practice Address - Fax:208-378-1322
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20938183500000X
AK216367183500000X
KS1-110099183500000X
IDP5820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP5820OtherSTATE LISCENSE