Provider Demographics
NPI:1386265361
Name:EATON, ASHLEY SHAY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHAY
Last Name:EATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 GUNBARREL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3126
Mailing Address - Country:US
Mailing Address - Phone:423-541-5102
Mailing Address - Fax:
Practice Address - Street 1:360 DELL TRL
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-5511
Practice Address - Country:US
Practice Address - Phone:423-949-4651
Practice Address - Fax:423-949-5652
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27348363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner