Individual
EILEEN MARGARET TAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2805 LYNDHURST AVE, WINSTON SALEM, NC 27103-4109
(336) 659-0076
(336) 659-0272
Mailing address
2805 LYNDHURST AVE, WINSTON SALEM, NC 27103-4109
(336) 659-0076
(336) 659-0272
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5008641
NC
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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