Provider Demographics
NPI:1154962751
Name:EATON, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:EATON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 HARARE LANE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856
Mailing Address - Country:US
Mailing Address - Phone:252-955-6329
Mailing Address - Fax:
Practice Address - Street 1:762 HARARE LANE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856
Practice Address - Country:US
Practice Address - Phone:252-955-6329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider