Provider Demographics
NPI:1609817808
Name:EADES, VICTORIA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LYNN
Last Name:EADES
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:807 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1941
Mailing Address - Country:US
Mailing Address - Phone:765-361-9767
Mailing Address - Fax:765-361-0374
Practice Address - Street 1:701 INGLEWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933
Practice Address - Country:US
Practice Address - Phone:765-361-9767
Practice Address - Fax:765-361-0374
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28156687A163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent