Provider Demographics
NPI:1053520486
Name:EVANCHO, DAWN PRISCILLA (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:PRISCILLA
Last Name:EVANCHO
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:218 ASHVILLE AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6118
Mailing Address - Country:US
Mailing Address - Phone:919-233-0410
Mailing Address - Fax:919-233-0872
Practice Address - Street 1:218 ASHVILLE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6118
Practice Address - Country:US
Practice Address - Phone:919-233-0410
Practice Address - Fax:919-233-0872
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2009-05-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC102457OtherLICENSE NUMBER