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General NPI Number Information
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NPI Number | 1710104955
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Entity Type | Individual
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Provider Name | DANIELLE ELSIE EADES PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2810 16TH ST NE # 200
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City | HICKORY
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State | NC
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Zip | 28601-9600
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Country | US
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Telephone | 704-237-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 POPS DR
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City | CATAWBA
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State | NC
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Zip | 28609-9085
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Country | US
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Telephone | 913-306-2494
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 004590
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAL-2637
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08010
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License Number State | NC
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