Provider Demographics
NPI:1659155562
Name:EAGLEN, MADDIE HOPE
Entity Type:Individual
Prefix:
First Name:MADDIE
Middle Name:HOPE
Last Name:EAGLEN
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 1:1137 BLAKE CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-9533
Mailing Address - Country:US
Mailing Address - Phone:615-663-9131
Mailing Address - Fax:
Practice Address - Street 1:2409 BANDERA DR APT D
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5296
Practice Address - Country:US
Practice Address - Phone:615-663-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula