Provider Demographics
NPI:1457947236
Name:DREW, ELIDA O (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIDA
Middle Name:O
Last Name:DREW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ELIDA
Other - Middle Name:ADDIS
Other - Last Name:OPITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 748613
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8613
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:
Practice Address - Street 1:493 BLACKWELL RD STE 202
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2689
Practice Address - Country:US
Practice Address - Phone:540-347-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily