Provider Demographics
NPI:1922678804
Name:EBY, ADRIENNE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:
Last Name:EBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:EBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0001
Mailing Address - Country:US
Mailing Address - Phone:814-877-6000
Mailing Address - Fax:
Practice Address - Street 1:2700 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9459
Practice Address - Country:US
Practice Address - Phone:919-587-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN662440163W00000X
NC6883367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN662440OtherPA RN LICENSE