MEDICARE: MISS CANDIE SUE MARCHAND EVANS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA.0005784	CO
2	363A00000X	Physician Assistant	PA.0005784	CO
3	363AS0400X	Surgical Physician Assistant	C0002822	MD

General Provider Information

NPI Number	:	1780721571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CANDIE SUE MARCHAND EVANS PA-C

Provider Business Mailing Address
First Line	:	9910 FRANKLIN SQUARE DR STE 2110
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21236-4902
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	6011 E WOODMEN RD STE 360
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2606
Country	:	US
Telephone Number	:	719-571-8550
Fax Number	:	719-571-8555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	02/09/2026

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