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General NPI Number Information
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NPI Number | 1285643080
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Entity Type | Individual
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Provider Name | KIMBERLY PERSHUN EVANS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 1500 E WOODROW WILSON AVE # 119
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City | JACKSON
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State | MS
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Zip | 39216-5116
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Country | US
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Telephone | 601-962-4471
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E WOODROW WILSON AVE # 119
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City | JACKSON
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State | MS
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Zip | 39216-5199
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Country | US
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Telephone | 601-962-4471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19290
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-27460
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-010117
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | E010117
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License Number State | MS
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