EUNICE THEODOR FNP NPI 1720471147

NPI Information

  • NPI: 1720471147
  • Provider Name: EUNICE THEODOR, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8820 HOSPITAL DR
    DOUGLASVILLE, GA
    ZIP 30134
  • Phone: (770) 947-3000

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NPI Details

Eunice Theodor, FNP is a family nurse practitioner in Douglasville, GA with 11 years of experience. Eunice Theodor, FNP NPI is 1720471147. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8820 HOSPITAL DR
DOUGLASVILLE, GA
ZIP 30134-266
Phone: (770) 947-3000
Fax: (770) 947-3012

The NPI 1720471147 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/10/2015 and was last updated on 9/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary Care0024172755VIRGINIANo
2363LF0000XNurse PractitionerFamilyRN244960GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720471147MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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