Moon, Evan Blake

Moon, Evan Blake is an individual health care provider with primary practice located at 2920 N Cascade Ave Ste 300 , Colorado Springs CO 80907-6262. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Moon, Evan Blake can be contacted via phone (719) 636-1201.

Contact Information

Primary practice address
2920 N Cascade Ave Ste 300 Colorado Springs CO 80907-6262
Phone: (719) 636-1201
Fax: (719) 636-1326
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN.0995199-CRNA Colorado
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 272878 North Carolina

Profile Details

NPI number 1437603891
LBN Legal business name Moon, Evan Blake
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2016
Last updated Dec 11th, 2024 - 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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