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General NPI Number Information
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NPI Number | 1598674236
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Entity Type | Organization
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Legal Business Name | EVERGREEN SURGICAL ASSIST
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 1024 S LEMAY AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-3929
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Country | US
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Telephone | 970-495-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3905 MELCER DR STE 601
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City | ROWLETT
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State | TX
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Zip | 75088-4033
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Authorized Official
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Title or Position | RN SURGICAL FIRST ASSIST
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Name | TAMI PERRIN
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Credential | BSN, RN, CNOR, RNFA
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Telephone | 970-218-2393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State |
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