Provider Demographics
NPI:1174843015
Name:HARPER, EILEEN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FLOYD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1318
Mailing Address - Country:US
Mailing Address - Phone:540-489-6353
Mailing Address - Fax:540-484-8552
Practice Address - Street 1:180 FLOYD AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151
Practice Address - Country:US
Practice Address - Phone:540-489-6353
Practice Address - Fax:540-484-8552
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170781367500000X
IL209008198367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered