Provider Demographics
NPI:1700568748
Name:STANLEY, EVA LEAH (FNP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:LEAH
Last Name:STANLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 HURRICANE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-5241
Mailing Address - Country:US
Mailing Address - Phone:304-946-8286
Mailing Address - Fax:
Practice Address - Street 1:947 OLD LOGAN RD
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3341
Practice Address - Country:US
Practice Address - Phone:304-831-0085
Practice Address - Fax:304-831-0088
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV117227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily