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Organization
EVERSIDE HEALTH LLC
Active
Organization
EVERSIDE HEALTH LLC
Active
Other names
Virtual Health Center Central East
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
2930 MONTVALE DR STE C, SPRINGFIELD, IL 62704-5376
(217) 280-5254
Mailing address
4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/17/2022
Last updated
10/19/2022
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