Provider Demographics
NPI:1588308357
Name:HADDAD, ELEANOR WILLIS
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:WILLIS
Last Name:HADDAD
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 1:112 FORREST VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5212
Mailing Address - Country:US
Mailing Address - Phone:412-841-3696
Mailing Address - Fax:
Practice Address - Street 1:346 21ST AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1848
Practice Address - Country:US
Practice Address - Phone:615-268-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program