MS. NANCY EAVES (NPI# 1255447645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255447645 |
| Entity Type | Individual |
| Full Name | MS. NANCY EAVES |
| Credential | CPNP |
| Practice Address |
433 Plaza St Ste 1a Bogalusa LA 70427-3729 |
| Mailing Address |
27 Lake Forgetful Hattiesburg MS 39402-7809 |
| Practice Telephone | 9857306970 |
| Practice Fax Number | 9857306398 |
| Mailing Telephone | 6016582640 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP10074 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APRN-2629 | HI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | CDS | 052841 | 01 |
| LA | 2478052 | 05 | |
| LA | STATE LICENSE | AP10074 | 01 |
| LA | DEA | ME4929672 | 01 |
| MS | 08278310 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18-1235 Volcano Road, Mountain View, HI 96771 | 8082868795 | 8889713856 |
| 234 S 12th Ave, Laurel, MS 394404325 | 6016493520 | 6016497899 |
| Street Address |
433 PLAZA ST STE 1A |
| City | BOGALUSA |
| State | LA |
| Zip Code | 70427-3729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467447185 | Mamatha Ananth | Pediatrics | 433 Plaza St Ste 1a, Bogalusa, LA 70427-3729 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871116368 | Lori Polk | Social Worker | 1640 S. Columbia St., Bogalusa, LA 70427 | 2020-05-19 |
| 1366914400 | Cherie Campbell | Case Manager/Care Coordinator | 311 Louisiana Avenue, Bogalusa, LA 70427 | 2018-12-31 |
| 1184134900 | Danielle Magee-keys | Counselor | 438 Ave U, Bogalusa, LA 70427 | 2017-10-06 |
| 1235656950 | House of Love, LLC | Foster Care Agency | 905 Davenport Ave, Bogalusa, LA 70427 | 2017-08-23 |
| 1811426315 | Shinetra Nicole Partman | Licensed Practical Nurse | 2106 Ave F, Bogalusa, LA 70427 | 2017-06-08 |
| 1265984082 | Behaviroal Health &wellness LLC | Community/Behavioral Health | 302 Richmond Street Suite A, Bogalousa, LA 70427 | 2016-10-27 |
| 1871942888 | Barry Warris Bolton | Community Health Worker | 712b Louisiana Ave, Bogalusa, LA 70427 | 2016-06-09 |
| 1376882696 | Judy Gail Jacobs | Licensed Practical Nurse | 619 Willis Avenue, Bogalusa Mental Health Center, Bogalusa, LA 70427 | 2013-02-06 |
| 1477836922 | Tuyet Le | Pharmacist | 329 Superior Avenue, Bogalusa, LA 70427 | 2011-09-21 |
| 1164755286 | Lorene A Randazzo | Dietitian, Registered | 433 Palm St, Bogalusa, LA 70427 | 2009-09-08 |
| Find all providers in zip 70427 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225414063 | Jacqueline Baudier Walter | Nurse Practitioner | 626 Superior Ave, Bogalusa, LA 70427-2631 | 2015-08-04 |
| 1922448968 | Julia Miller Kreger | Nurse Practitioner | 100 M J Israel Dr, Bogalusa, LA 70427-3757 | 2013-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138473 | Nickolas Matthews | Nurse Practitioner | 1307 Crowley Rayne Hwy Ste B, Crowley, LA 70526-8210 | 2020-09-14 |
| 1841809258 | Brandi Schwab | Nurse Practitioner | 157 Belington Ave, Madisonville, LA 70447-9109 | 2020-07-31 |
| 1780293878 | Cornerstone Childrens Clinic LLC | Nurse Practitioner | 44546 S Airport Rd Ste F, Hammond, LA 70403-0312 | 2020-07-24 |
| 1629691530 | Bayou Pediatrics | Nurse Practitioner | 2649 Arkansas Rd, West Monroe, LA 71291-8617 | 2020-05-27 |
| 1295376374 | Tatjana Michele Mimes | Nurse Practitioner | 3975 I 49 S Service Rd Ste 201, Opelousas, LA 70570-0775 | 2019-09-30 |
| 1063067411 | Arwa Mohammed Mohammed | Nurse Practitioner | 101 Medical Park Blvd Ste A, Pineville, LA 71360-8426 | 2019-08-02 |
| 1477118065 | Erin L Hurt | Nurse Practitioner | 59101 Amber St, Slidell, LA 70461-3708 | 2019-05-08 |
| 1033679501 | Laura Elizabeth Williamson | Nurse Practitioner | 501 Medical Center Dr Ste 100, Alexandria, LA 71301-8124 | 2019-03-21 |
| 1043703010 | Samantha Lee Lovecchio | Nurse Practitioner | 120 Ochsner Blvd Ste 245, Gretna, LA 70056-5280 | 2018-06-13 |
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.