Provider Demographics
NPI:1154597383
Name:EATON, NANCY CARSON (OTR/L)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:CARSON
Last Name:EATON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 US HIGHWAY 158 W
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-8246
Mailing Address - Country:US
Mailing Address - Phone:252-209-9865
Mailing Address - Fax:
Practice Address - Street 1:604 STOKES ST E
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-4159
Practice Address - Country:US
Practice Address - Phone:252-332-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4088225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist