Healthcare Provider Details

I. General information

NPI: 1700701356
Provider Name (Legal Business Name): CHRISTINA EVENSON PHARMACY TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N WILMOT RD # 151
TUCSON AZ
85711-2701
US

IV. Provider business mailing address

603 N WILMOT RD # 151
TUCSON AZ
85711-2701
US

V. Phone/Fax

Practice location:
  • Phone: 520-420-2982
  • Fax: 520-420-2602
Mailing address:
  • Phone: 520-420-2982
  • Fax: 520-420-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT034255
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: