Ivie, Evan Dayne

Ivie, Evan Dayne is an individual health care provider with primary practice located at 14502 W Meeker Blvd , Sun City West AZ 85375-5282. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Ivie, Evan Dayne can be contacted via phone (623) 524-4607.

Contact Information

Primary practice address
14502 W Meeker Blvd Sun City West AZ 85375-5282
Phone: (623) 524-4607
Fax: (623) 524-4182
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5905 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1265 Idaho

Profile Details

NPI number 1558765891
LBN Legal business name Ivie, Evan Dayne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2014
Last updated Apr 13th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558765891 NPPES
Idaho MEDICAID 1174919534
Idaho MEDICAID 473675862

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