Provider Demographics
NPI:1518589027
Name:REES, ELIANA MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIANA
Middle Name:MARIE
Last Name:REES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ELIANA
Other - Middle Name:MARIE
Other - Last Name:VAEZAZIZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2015 GUM BRANCH RD APT 223
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4598
Mailing Address - Country:US
Mailing Address - Phone:951-760-6485
Mailing Address - Fax:
Practice Address - Street 1:317 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6338
Practice Address - Country:US
Practice Address - Phone:910-577-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant