Provider Demographics
NPI:1235243007
Name:EDDY, STEVEN HEWES (FNP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:HEWES
Last Name:EDDY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 SW RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527
Mailing Address - Country:US
Mailing Address - Phone:541-476-6644
Mailing Address - Fax:541-472-5673
Practice Address - Street 1:495 SW RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527
Practice Address - Country:US
Practice Address - Phone:541-476-6644
Practice Address - Fax:541-472-5673
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR091000510363LF0000X
CANP95027074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
133701Medicare ID - Type Unspecified
R97399Medicare UPIN