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General NPI Number Information
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NPI Number | 1255447645
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Entity Type | Individual
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Provider Name | NANCY EAVES APRN
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 3333 UNIVERSITY AVE SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-3325
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Country | US
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Telephone | 612-767-7222
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Fax |
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Provider Business Mailing Address
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Address Line | 425 BIG BAY BLVD
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City | LUMBERTON
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State | MS
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Zip | 39455-5938
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Country | US
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Telephone | 601-658-2640
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 8720
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License Number State | MN
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