Provider Demographics
NPI:1013126465
Name:EDDY, CECILIA LONNETTE
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:LONNETTE
Last Name:EDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:LONNETTE
Other - Last Name:SEDGWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:812 VICTORIA BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-2538
Mailing Address - Country:US
Mailing Address - Phone:757-223-0163
Mailing Address - Fax:757-310-6223
Practice Address - Street 1:812 VICTORIA BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-2538
Practice Address - Country:US
Practice Address - Phone:757-223-0163
Practice Address - Fax:757-310-6223
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel