Healthcare Provider Details

I. General information

NPI: 1477317329
Provider Name (Legal Business Name): EUNICE LATANYA EADDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 FAIRBLUFF DR
HOPE MILLS NC
28348-5671
US

IV. Provider business mailing address

623 FAIRBLUFF DR
HOPE MILLS NC
28348-5671
US

V. Phone/Fax

Practice location:
  • Phone: 843-625-9208
  • Fax:
Mailing address:
  • Phone: 843-625-9208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: