Provider Demographics
NPI:1659958163
Name:ELEANOR HEALTH PROFESSIONAL NC, PLLC
Entity Type:Organization
Organization Name:ELEANOR HEALTH PROFESSIONAL NC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NZINGA
Authorized Official - Middle Name:AJABU
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-419-0858
Mailing Address - Street 1:PO BOX 2810
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-2810
Mailing Address - Country:US
Mailing Address - Phone:828-989-8686
Mailing Address - Fax:
Practice Address - Street 1:3013 SENNA DR STE A
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-6727
Practice Address - Country:US
Practice Address - Phone:866-588-0977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEANOR HEALTH PROFESSIONAL NC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty