Provider Demographics
NPI:1114285749
Name:SOUDER, EILEEN K (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:K
Last Name:SOUDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:519 S 5TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1042
Mailing Address - Country:US
Mailing Address - Phone:215-257-8601
Mailing Address - Fax:215-257-8657
Practice Address - Street 1:211 TELFORD PIKE
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-2251
Practice Address - Country:US
Practice Address - Phone:215-723-7833
Practice Address - Fax:215-723-2904
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASPO11914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily