Provider Demographics
NPI:1306334750
Name:EYA, BLESSING O
Entity type:Individual
Prefix:MS
First Name:BLESSING
Middle Name:O
Last Name:EYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 STEPHEN WAY
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1159
Mailing Address - Country:US
Mailing Address - Phone:304-444-5179
Mailing Address - Fax:681-217-1282
Practice Address - Street 1:5312 MORNING DOVE LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25313-1154
Practice Address - Country:US
Practice Address - Phone:304-444-5179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility