Provider Demographics
NPI:1811954696
Name:FELTS, EVA JANE (RN ANP)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:JANE
Last Name:FELTS
Suffix:
Gender:F
Credentials:RN ANP
Other - Prefix:
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Mailing Address - Street 1:3817 FORRESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2930
Mailing Address - Country:US
Mailing Address - Phone:336-765-9314
Mailing Address - Fax:336-765-6610
Practice Address - Street 1:3817 FORRESTGATE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2930
Practice Address - Country:US
Practice Address - Phone:336-765-9314
Practice Address - Fax:336-765-6610
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC900022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner