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General NPI Number Information
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NPI Number | 1306671722
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Entity Type | Individual
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Provider Name | JADA EVANS PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 1214 POSTON PL SE
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City | SMYRNA
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State | GA
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Zip | 30080-1912
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Country | US
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Telephone | 205-447-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 1214 POSTON PL SE
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City | SMYRNA
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State | GA
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Zip | 30080-1912
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Country | US
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Telephone |
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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 | RPH029039
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License Number State | GA
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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 | 19222
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License Number State | NV
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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 | T100-446
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS61869
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.293937
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License Number State | IL
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