Healthcare Provider Details

I. General information

NPI: 1780159111
Provider Name (Legal Business Name): ELEANOR ANN COLMENARES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1463 BROOKHAVEN DR
ROCKINGHAM VA
22801-3584
US

IV. Provider business mailing address

1463 BROOKHAVEN DR
ROCKINGHAM VA
22801-3584
US

V. Phone/Fax

Practice location:
  • Phone: 904-304-5405
  • Fax:
Mailing address:
  • Phone: 540-215-0082
  • Fax: 833-972-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024176744
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024176744
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: