Provider Demographics
NPI:1205616372
Name:WINGO, EVA (CD (DONA))
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:WINGO
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5117 S MELODY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-4229
Mailing Address - Country:US
Mailing Address - Phone:718-813-4263
Mailing Address - Fax:
Practice Address - Street 1:340 W 42ND ST UNIT 332
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10108-1511
Practice Address - Country:US
Practice Address - Phone:917-528-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174400000XOther Service ProvidersSpecialist