KATHLEEN EYSENBACH (NPI# 1740541374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740541374 |
Entity Type | Individual |
Full Name | KATHLEEN EYSENBACH |
Practice Address |
Old Dominion University Webb Center Student Health Center Norfolk VA 23529-0001 |
Practice Telephone | 7576833132 |
Enumeration Date | 2012-05-30 |
Last Update Date | 2012-05-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110000121 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
OLD DOMINION UNIVERSITY WEBB CENTER STUDENT HEALTH CENTER |
City | NORFOLK |
State | VA |
Zip Code | 23529-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689792798 | Jason Christopher Mitchell | Specialist/Technologist | Old Dominion University, Athletic Administration Building #1113c, Norfolk, VA 23529-0001 | 2007-03-27 |
1508387572 | Janelle A Prince | Specialist/Technologist | Old Dominion University, Norfolk, VA 23529-0001 | 2017-06-29 |
1538406327 | Megan Hammonds | Specialist/Technologist | Old Dominion University, Jim Jarrett Athletic Administration Building, Norfolk, VA 23529-0201 | 2013-01-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528681939 | Breanna Jo Davis | Student in an Organized Health Care Education/Training Program | 5115 Hampton Boulevard, Norfolk, VA 23529-0001 | 2020-05-20 |
1912564311 | Briana M Lawry | Specialist/Technologist | 4608 Hampton Blvd, Norfolk, VA 23529-0001 | 2019-05-22 |
1679054035 | Charles Marshall Mozena | Specialist/Technologist | 4700 Powhatan Avenue, Norfolk, VA 23529-0001 | 2018-08-23 |
1669960258 | Dana Slepsky Robertson | Speech-Language Pathologist | 1015 W 47th Street, Norfolk, VA 23529-0001 | 2018-04-29 |
1326548140 | Trevor Thompson | Specialist/Technologist | Old Dominion University 5115 Hampton Blvd, Norfolk, VA 23529-0001 | 2018-02-19 |
1104335629 | Michael Andrew Burkeitt | Specialist/Technologist | 4500 Parker Avenue, Norfolk, VA 23529-0001 | 2017-09-27 |
1437682705 | Robert Medina | Specialist/Technologist | 4500 Parker Ave, Norfolk, VA 23529-0001 | 2017-04-04 |
1053767426 | Michael Olson | Specialist/Technologist | Jim Jarrett Athletic Admin Building, Norfolk, VA 23529-0001 | 2016-05-04 |
1144639568 | Heather Mckay Byrne | Physical Therapist | Odu Monarch Physical Therapy, 1015 West 47th Street, Norfolk, VA 23529-0001 | 2014-08-11 |
1770991051 | Cori Winifred Sinnott | Specialist/Technologist | 5115 Hampton Blvd, Norfolk, VA 23529-0001 | 2014-07-30 |
Find all providers in zip 23529 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
1205345584 | Cassandra Lee Elverum | Physician Assistant | 600 Childrens Ln, Norfolk, VA 23507 | 2017-09-29 |
1790904456 | Thomas George Parish | Physician Assistant | 700 W Olney Rd, Norfolk, VA 23507-1607 | 2007-04-24 |
1649345372 | Ronald E Nave | Physician Assistant | 814 Kempsville Rd Ste 104, Norfolk, VA 23502-4001 | 2006-11-21 |
1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
1902876931 | Mark Alan Gellasch | Physician Assistant | Branch Medical Clinic Norfolk, 1721 Taussig Blvd, Norfolk, VA 23511 | 2006-01-24 |
1073132551 | Ashley Makie | Physician Assistant | 3 Cedar St, Norfolk, MA 02056-1566 | 2020-04-14 |
1376179465 | Emily J Laughlin | Physician Assistant | 6379 Center Dr, Norfolk, VA 23502-4102 | 2020-03-20 |
1629604095 | Erin Anne Gray | Physician Assistant | 100 Kingsley Ln Ste 400, Norfolk, VA 23505-4604 | 2020-03-18 |
Find all providers in NORFOLK |
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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.