Provider Demographics
NPI:1952318370
Name:EISELE, NANCY BARBARA (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:BARBARA
Last Name:EISELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 BREMO RD STE 128A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2444
Mailing Address - Country:US
Mailing Address - Phone:877-969-0392
Mailing Address - Fax:
Practice Address - Street 1:1845 PLAZA DR
Practice Address - Street 2:EYE ASSOCIATES OF WINCHESTER INC
Practice Address - City:WICHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-662-4512
Practice Address - Fax:540-722-5284
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042504207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006310508Medicaid
VA052133OtherANTHEM BCBS