Evangeline Eley
Individual provider Active NPI Private Vehicle · Zuni, VA
NPI 1629569322 · NPPES record last updated May 29, 2018
Key facts
- NPI
- 1629569322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- T61537425 (VA)
- Practice address
- 37112 Seacock Chapel Rd
Zuni, VA 23898-3342 - Phone
- (757) 617-6852
- NPI assigned
- May 29, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T61537425 | VA | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T61537425 | VA | Yes |
Addresses
Primary practice location
37112 Seacock Chapel Rd
Zuni, VA 23898-3342
Mailing address
37112 Seacock Chapel Rd
Zuni, VA 23898-3342
Phone (757) 617-6852
Other providers in Zuni, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.