Individual
MS. NANCY EAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 767-7222
Mailing address
425 BIG BAY BLVD, LUMBERTON, MS 39455-5938
(601) 658-2640
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
8720
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052841
CDS
LA
05
—
08278310
—
MS
05
—
2478052
—
LA
01
—
AP10074
STATE LICENSE
LA
Enumeration date
08/21/2006
Last updated
12/06/2021
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