Individual provider Active NPI

Eileen Sharon Wren, MSN RN

  • Case Management Registered Nurse
  • Fort Eustis, VA
National Provider Identifier
1770636615
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
0001069188 Issued in VA
Practice address
McDonald Army Health Center
576 Jefferson Ave
Fort Eustis, VA 23604-5548
Phone
(757) 314-7522
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 0001069188 VA Primary

Addresses

Primary practice location

McDonald Army Health Center
576 Jefferson Ave
Fort Eustis, VA 23604-5548

Mailing address

2515 Cypress Avenue
Virginia Beach, VA 23451
Phone (757) 233-9477

Other identifiers 1

IdentifierTypeStateIssuer
0001069188OtherVAREGISTERED NURSE LICENSE

Other names 1

  • Mrs. Eileen Sharon Crowder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001069188VAMDCase Management Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1770636615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 CYPRESS AVENUE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "757-233-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCDONALD ARMY HEALTH CENTER",
            "address_2": "576 JEFFERSON AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045548",
            "telephone_number": "757-314-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "EILEEN",
        "middle_name": "SHARON",
        "name_prefix": "Mrs.",
        "credential": "MSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "VA",
            "license": "0001069188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "0001069188",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "CROWDER",
            "middle_name": "SHARON",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Eustis, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.