Individual
EILEEN A IRVIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-5104
Mailing address
PO BOX 33087, KNOXVILLE, TN 37930-3087
(865) 691-2993
(865) 691-2997
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN1066220/ARNP1475A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001227495
CHA
KY
01
—
000000392243
ANTHEM BCBS KY
KY
01
—
C20357
CUMBERLAND HEALTH CARE
KY
Enumeration date
05/17/2006
Last updated
07/08/2007
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