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Individual

MIKAYLA EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
535 E 17TH ST, IDAHO FALLS, ID 83404-6154
(208) 542-4569
Mailing address
352 WIND RIVER DR, SHELLEY, ID 83274-2101

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1771071
ID

Other

Enumeration date
11/13/2025
Last updated
11/13/2025
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