Provider Demographics
NPI: | 1134344302 |
---|---|
Name: | PARDUE, ELEANOR F (NEONATAL NURSE PRACT) |
Entity type: | Individual |
Prefix: | MS |
First Name: | ELEANOR |
Middle Name: | F |
Last Name: | PARDUE |
Suffix: | |
Gender: | F |
Credentials: | NEONATAL NURSE PRACT |
Other - Prefix: | MS |
Other - First Name: | ELEANOR |
Other - Middle Name: | F |
Other - Last Name: | DUTY-PARDUE |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | NEONATAL NURSE PRACT |
Mailing Address - Street 1: | 2080 CHILD ST NAVAL HOSPITAL AT JACKSONVILLE |
Mailing Address - Street 2: | MOTHER INFANT UNIT |
Mailing Address - City: | JACKSONVILLE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32212 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 904-322-9582 |
Mailing Address - Fax: | 904-542-7046 |
Practice Address - Street 1: | 2080 CHILD ST NAVAL HOSPITAL AT JACKSONVILLE |
Practice Address - Street 2: | MOTHER INFANT UNIT |
Practice Address - City: | JACKSONVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32212 |
Practice Address - Country: | US |
Practice Address - Phone: | 904-322-9582 |
Practice Address - Fax: | 904-542-7046 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-04-14 |
Last Update Date: | 2018-02-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ARNP 9164683 | 363LN0000X |
FL | RN9459062 | 363LN0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LN0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |