Provider Demographics
NPI:1609637933
Name:EDDY, JOANNA SINGER
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:SINGER
Last Name:EDDY
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 1:11193 MANOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5857
Mailing Address - Country:US
Mailing Address - Phone:802-734-5655
Mailing Address - Fax:
Practice Address - Street 1:11193 MANOR VIEW DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-5857
Practice Address - Country:US
Practice Address - Phone:802-734-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001286710163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice