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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