Provider Demographics
NPI:1255126017
Name:PIRTLE, EILEEN M
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:PIRTLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 COVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5604
Mailing Address - Country:US
Mailing Address - Phone:805-750-0339
Mailing Address - Fax:
Practice Address - Street 1:2023 COVINGTON AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-5604
Practice Address - Country:US
Practice Address - Phone:805-750-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider