Provider Demographics
NPI:1689776494
Name:EADS, NADINE LYNELL (RN)
Entity Type:Individual
Prefix:MS
First Name:NADINE
Middle Name:LYNELL
Last Name:EADS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 COWLING CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-7318
Mailing Address - Country:US
Mailing Address - Phone:703-313-6300
Mailing Address - Fax:
Practice Address - Street 1:6901 S VAN DORN ST
Practice Address - Street 2:
Practice Address - City:KINGSTOWNE
Practice Address - State:VA
Practice Address - Zip Code:22315-3961
Practice Address - Country:US
Practice Address - Phone:703-313-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001110082163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health