Individual
MRS. LISA RACHELLE EVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1175 S PERRY ST, SUITE 200, CASTLE ROCK, CO 80104-1969
(303) 688-3434
(303) 688-4454
Mailing address
1175 S PERRY ST, SUITE 200, CASTLE ROCK, CO 80104-1969
(303) 688-3434
(303) 688-4454
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2242
CO
Other
Enumeration date
11/12/2006
Last updated
01/02/2013
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