Provider Demographics
NPI:1619852019
Name:NUMBERS, EDEN (BSN, RN)
Entity type:Individual
Prefix:
First Name:EDEN
Middle Name:
Last Name:NUMBERS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:EDEN
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10425 DEVILS LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:MI
Mailing Address - Zip Code:49220-9538
Mailing Address - Country:US
Mailing Address - Phone:517-442-6625
Mailing Address - Fax:
Practice Address - Street 1:107 CHICAGO ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-9703
Practice Address - Country:US
Practice Address - Phone:517-592-1644
Practice Address - Fax:517-592-1975
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704383395163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management