Provider Demographics
NPI:1821010117
Name:FLOYD, EILEEN F (CRNA)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:F
Last Name:FLOYD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:F
Other - Last Name:O'MALLEY-FLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-0254
Mailing Address - Country:US
Mailing Address - Phone:610-325-0170
Mailing Address - Fax:
Practice Address - Street 1:1600 ROCKLAND ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4200
Practice Address - Fax:302-651-5365
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL6-0A00348367500000X
DEL10030557367500000X, 367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA008681Medicare ID - Type Unspecified