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General NPI Number Information
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NPI Number | 1932789591
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Entity Type | Individual
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Provider Name | ARIEL MARIA EANES
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 205 ROANOKE ST
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-3025
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Country | US
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Telephone | 540-381-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone | 540-224-5353
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0116035765
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License Number State | VA
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