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General NPI Number Information
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NPI Number | 1831995588
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Entity Type | Individual
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Provider Name | KRISTEN L EBERHARDT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 8001 GOLF COURSE DR N
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City | DENVER
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State | NC
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Zip | 28037-9173
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Country | US
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Telephone | 630-248-6343
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Fax | 630-554-6778
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Provider Business Mailing Address
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Address Line | 8001 GOLF COURSE DR N
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City | DENVER
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State | NC
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Zip | 28037-9173
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Country | US
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Telephone | 630-248-6343
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Fax | 630-554-6778
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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