MEDICARE: PATRICIA EUBANKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024178872	VA
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	0024178872	VA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	402935	NY

General Provider Information

NPI Number	:	1235762337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA EUBANKS

Provider Business Mailing Address
First Line	:	5301 PROVIDENCE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4128
Country	:	US
Telephone Number	:	757-347-8840
Fax Number	:	757-829-1667

Provider Business Practice Location Address
First Line	:	5301 PROVIDENCE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4128
Country	:	US
Telephone Number	:	757-347-8840
Fax Number	:	757-829-1667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2020
Last Update Date	:	12/30/2025

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Directions to “ PATRICIA EUBANKS ” Practice Location

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