Provider Demographics
NPI:1902195944
Name:EICHNER, ANN TERESA (RN, CRRN, CCM, QRP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:TERESA
Last Name:EICHNER
Suffix:
Gender:F
Credentials:RN, CRRN, CCM, QRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 OAK HAVEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-964-1602
Mailing Address - Fax:407-964-1170
Practice Address - Street 1:458 OAK HAVEN DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6318
Practice Address - Country:US
Practice Address - Phone:407-964-1602
Practice Address - Fax:407-964-1170
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL557092163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse