CANDYCE K EVANSON (NPI# 1871510735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871510735 |
| Entity Type | Individual |
| Full Name | CANDYCE K EVANSON |
| Credential | PA-C |
| Practice Address |
737 Broadway Fargo ND 58122 |
| Mailing Address |
737 Broadway Fargo ND 58122-0001 |
| Practice Telephone | 7012343360 |
| Practice Fax Number | 7012343868 |
| Mailing Telephone | 7012343360 |
| Mailing Fax Number | 7012343868 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 9215 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | PAC0168 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
9215 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
737 BROADWAY |
| City | FARGO |
| State | ND |
| Zip Code | 58122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437103959 | Robin J Sickels | Dietitian, Registered | 737 Broadway, Fargo, ND 58122-0001 | 2006-05-20 |
| 1679883680 | Summer Schauer | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2010-10-13 |
| 1588974596 | Melissa Vanmatre | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2010-10-13 |
| 1164652640 | Sanford Clinic North | Clinical Medical Laboratory | 737 Broadway, Fargo, ND 58122-0045 | 2009-07-20 |
| 1710138375 | Kent C Moser | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2008-10-01 |
| 1023268711 | Katie C Busker | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122 | 2008-09-30 |
| 1770731473 | Andrea B Peterson | Nurse Practitioner | 737 Broadway, Fargo, ND 58122-0001 | 2008-09-05 |
| 1801091384 | Vijay Korimilli | Internal Medicine | 737 Broadway, Fargo, ND 58122-0001 | 2007-06-15 |
| 1437362571 | Heidi J Lako-adamson | Emergency Medicine | 737 Broadway, Fargo, ND 58122-0001 | 2007-05-07 |
| 1164567970 | Kristen M Liebl | Dietary Manager | 737 Broadway, Fargo, ND 58122-0001 | 2007-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184142747 | Kayla Estepp | Internal Medicine | 737 Broadway North, Fargo, ND 58122 | 2017-09-05 |
| 1376091793 | Paul Mckay | Physical Therapist | 801 Broadway N., Fargo, ND 58122 | 2016-09-14 |
| 1801290150 | Mark Noah | Physical Therapist | 1720 South University, Fargo, ND 58122 | 2014-10-15 |
| 1245633486 | Diana Palm | Physical Therapist | 1720 University Drive South, Fargo, ND 58122 | 2014-10-02 |
| 1447696406 | Mohamad Imam | Internal Medicine | 801 Broadway North, Fargo, ND 58122 | 2013-05-17 |
| 1457615155 | Chantee Seung Gruenhagen | Nurse Practitioner | 737 North Broadway, Sanford Urology Clinic, Fargo, ND 58122 | 2012-06-27 |
| 1457594079 | Manisha Balhara | Specialist | 2400 32nd Avenue S, Fargo, ND 58122 | 2009-04-13 |
| 1578536728 | Shelby A Terstriep | Internal Medicine | 820 4 Street North, Fargo, NC 58122 | 2006-02-08 |
| 1295229946 | Christopher Hinh | Student in an Organized Health Care Education/Training Program | 801 Broadway North, Fargo, ND 58122 | 2018-06-17 |
| 1558854539 | Suchita Kotnala | Family Medicine | 737 Broadway North, Fargo, ND 58122 | 2018-06-13 |
| Find all providers in zip 58122 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033665310 | Caitlyn R Cameron | Physician Assistant | 4110 51st Ave South, Fargo, ND 58104 | 2016-08-28 |
| 1295069664 | Megan Jean Boose | Physician Assistant | 3173 43rd St S Ste A, Fargo, ND 58104-4564 | 2009-10-01 |
| 1487715405 | Nancy M Eastman | Physician Assistant | 4622 40th Ave S, Fargo, ND 58104-4394 | 2006-12-13 |
| 1700826369 | Jeanne Waalen | Physician Assistant | 4200 Woodhaven St Sw, Fargo, ND 58104-3946 | 2006-06-08 |
| 1982642773 | Linda K Regan | Physician Assistant | 1800 21st Avenue South, Fargo, ND 58103 | 2006-06-03 |
| 1437153905 | Jay R Metzger | Physician Assistant | 306 4th St N, Fargo, ND 58102-4820 | 2005-06-13 |
| 1538786728 | Peter V Tronset | Physician Assistant | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-03 |
| 1750908455 | Jordan Ann Wiedmann | Physician Assistant | 3201 33rd St S, Fargo, ND 58104-8823 | 2020-06-29 |
| 1144842089 | Matthew Hockert | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-05-14 |
| 1770110777 | Steffani Nicole Johnston Mack | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-03-27 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.