Provider Demographics
NPI:1962570127
Name:HALSTEAD, ELENI (RN)
Entity type:Individual
Prefix:MS
First Name:ELENI
Middle Name:
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3369 TALEEN CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1161
Mailing Address - Country:US
Mailing Address - Phone:703-204-0182
Mailing Address - Fax:
Practice Address - Street 1:14150 PARKEAST CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2295
Practice Address - Country:US
Practice Address - Phone:703-968-4000
Practice Address - Fax:703-263-1724
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001135102163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health