Provider Demographics
NPI:1124340922
Name:BENTLEY-FORCE, EOLA ANNE (FNP)
Entity type:Individual
Prefix:MS
First Name:EOLA
Middle Name:ANNE
Last Name:BENTLEY-FORCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72650 FRED WARING DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5006
Mailing Address - Country:US
Mailing Address - Phone:760-776-7999
Mailing Address - Fax:760-776-7994
Practice Address - Street 1:72650 FRED WARING DR
Practice Address - Street 2:SUITE 214
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5006
Practice Address - Country:US
Practice Address - Phone:760-776-7999
Practice Address - Fax:760-776-7994
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily