Provider Demographics
NPI:1518289081
Name:CRAIGHEAD, ELEANOR ROSE (RN)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:ROSE
Last Name:CRAIGHEAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:VA
Mailing Address - Zip Code:24165-3057
Mailing Address - Country:US
Mailing Address - Phone:276-957-2402
Mailing Address - Fax:276-957-2402
Practice Address - Street 1:1731 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:VA
Practice Address - Zip Code:24165-3057
Practice Address - Country:US
Practice Address - Phone:276-957-2402
Practice Address - Fax:276-957-2402
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001153362163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse