Basic Information
| Provider Information | |||||||||
| NPI: | 1538457601 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDDOWES | ||||||||
| FirstName: | JEANNETTE | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | RN, MSN, CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2112 HARRISBURG PIKE | ||||||||
| Address2: | STE 312 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443022 | ||||||||
| FaxNumber: | 7175443021 | ||||||||
| Practice Location | |||||||||
| Address1: | 2112 HARRISBURG PIKE | ||||||||
| Address2: | STE 312 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443022 | ||||||||
| FaxNumber: | 7175443021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2011 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SP001002H | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.