Provider Demographics
NPI:1588861207
Name:EUBANK, ABIGAIL JOAN (MSN, GNP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:JOAN
Last Name:EUBANK
Suffix:
Gender:F
Credentials:MSN, GNP
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:JOAN
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, GNP
Mailing Address - Street 1:105 GLEN OAK BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3058
Mailing Address - Country:US
Mailing Address - Phone:615-826-2265
Mailing Address - Fax:615-826-4616
Practice Address - Street 1:105 GLEN OAK BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3058
Practice Address - Country:US
Practice Address - Phone:615-826-2265
Practice Address - Fax:615-826-4616
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN127334163WG0600X, 163WG0600X
TNAPN8044363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3908465Medicare PIN
TNP27476Medicare UPIN