Provider Demographics
NPI:1467876383
Name:EADS, NOELLE M (DPT)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:M
Last Name:EADS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:M
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:207 N BOONE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-5675
Mailing Address - Country:US
Mailing Address - Phone:423-662-4100
Mailing Address - Fax:423-205-2444
Practice Address - Street 1:207 N BOONE ST STE 300
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5675
Practice Address - Country:US
Practice Address - Phone:423-662-4100
Practice Address - Fax:423-205-2444
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN98992251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ005452Medicaid