Provider Demographics
NPI:1518010040
Name:DOVER, EILEEN A (CNM APRN, MS)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:A
Last Name:DOVER
Suffix:
Gender:F
Credentials:CNM APRN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 COUNTY ROAD 1801
Mailing Address - Street 2:
Mailing Address - City:HOLLY POND
Mailing Address - State:AL
Mailing Address - Zip Code:35083-5336
Mailing Address - Country:US
Mailing Address - Phone:256-727-0822
Mailing Address - Fax:
Practice Address - Street 1:GEORGIA CENTER FOR FEMALE HEALTH
Practice Address - Street 2:3660 FLAT SHOALS RD. SUITE 180
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-3003
Practice Address - Country:US
Practice Address - Phone:404-243-7777
Practice Address - Fax:404-284-7676
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN187527176B00000X
AL1-059372367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA464145085AMedicaid