Provider Demographics
NPI:1477317329
Name:EADDY, EUNICE LATANYA
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:LATANYA
Last Name:EADDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 FAIRBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-5671
Mailing Address - Country:US
Mailing Address - Phone:843-625-9208
Mailing Address - Fax:
Practice Address - Street 1:623 FAIRBLUFF DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-5671
Practice Address - Country:US
Practice Address - Phone:843-625-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide