Provider Demographics
NPI:1982607099
Name:HESS, ELEANOR (FNP)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:
Last Name:HESS
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 1:999 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4632
Mailing Address - Country:US
Mailing Address - Phone:423-224-3250
Mailing Address - Fax:423-224-3258
Practice Address - Street 1:391 FALLS DR NW
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-8093
Practice Address - Country:US
Practice Address - Phone:276-628-4406
Practice Address - Fax:276-628-4906
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164291363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982607099Medicaid
TN3658784Medicaid
TN3640148Medicaid
VA010118123Medicaid
Q22861Medicare UPIN
VA1982607099Medicaid
TN3640148Medicaid
VAV V5970AMedicare PIN
TN0281780001Medicare PIN
TN3700592Medicare UPIN
VA010118123Medicaid
VACA0736Medicare PIN
VAC09094Medicare PIN
TN0281780003Medicare PIN
VAVAA103454Medicare PIN
TN3658784Medicaid
VAP00813617Medicare PIN
VA005334H94Medicare PIN