Provider Demographics
NPI:1932789591
Name:EANES, ARIEL MARIA
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:MARIA
Last Name:EANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:MARIA
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 ALLEGHANY ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-5209
Mailing Address - Country:US
Mailing Address - Phone:804-912-3064
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-981-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program