Individual
MRS. KRISSY EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PD
Contact information
Practice address
2104 WILLIAMS BLVD, KENNER, LA 70062-5806
(504) 469-0973
Mailing address
PO BOX 843, HAHNVILLE, LA 70057-0843
(504) 201-3422
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17463
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17463
PHARMACY
LA
Enumeration date
04/03/2007
Last updated
07/08/2007
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