Provider Demographics
NPI:1861980393
Name:VIRREY, EILEEN CAOILE (FNP-BC,APRN,BSN,RN)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:CAOILE
Last Name:VIRREY
Suffix:
Gender:F
Credentials:FNP-BC,APRN,BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 CROSSROADS STREET
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2429
Mailing Address - Country:US
Mailing Address - Phone:619-254-1905
Mailing Address - Fax:
Practice Address - Street 1:1840 CROSSROADS STREET
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2429
Practice Address - Country:US
Practice Address - Phone:619-254-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily