Provider Demographics
NPI:1316103179
Name:ESHAM, DE ANN
Entity type:Individual
Prefix:MS
First Name:DE ANN
Middle Name:
Last Name:ESHAM
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 1:75 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-7612
Mailing Address - Country:US
Mailing Address - Phone:606-796-9445
Mailing Address - Fax:
Practice Address - Street 1:75 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-7612
Practice Address - Country:US
Practice Address - Phone:606-796-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator