Healthcare Provider Details

I. General information

NPI: 1619320744
Provider Name (Legal Business Name): WHITNEY EBERLY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 PORT REPUBLIC RD
ROCKINGHAM VA
22801-3533
US

IV. Provider business mailing address

327 DRY RIVER RD
BRIDGEWATER VA
22812-1243
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-6613
  • Fax:
Mailing address:
  • Phone: 540-908-1179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024173734
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: