Provider Demographics
NPI:1205164142
Name:EISON, ACHICK P (LPN)
Entity type:Individual
Prefix:MISS
First Name:ACHICK
Middle Name:P
Last Name:EISON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LOUGEAY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4502
Mailing Address - Country:US
Mailing Address - Phone:412-727-1389
Mailing Address - Fax:
Practice Address - Street 1:301 LOUGEAY RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-4502
Practice Address - Country:US
Practice Address - Phone:412-727-1389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN265182164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse