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NPI Code Detail

MEDICARE: MRS. SANDY HAN EVANSON PA-C

MEDICARE: MRS. SANDY HAN EVANSON 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
1363A00000XPhysician AssistantC0004770MD

General Provider Information

NPI Number : 1922267947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDY HAN EVANSON PA-C
Provider Business Mailing Address
First Line : 2415 MUSGROVE RD
Second Line : STE 105
City : SILVER SPRING
State : MD
Zip : 20904-5224
Country : US
Telephone Number : 804-484-2098
Fax Number :
Provider Business Practice Location Address
First Line : 2415 MUSGROVE RD STE 105
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-5224
Country : US
Telephone Number : 301-989-0193
Fax Number : 301-989-3464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2008
Last Update Date : 07/10/2018

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