Provider Demographics
NPI:1427713510
Name:EATON, BRITTANY NICHOLE (NP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:EATON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270653
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-0653
Mailing Address - Country:US
Mailing Address - Phone:149-745-7253
Mailing Address - Fax:
Practice Address - Street 1:300 FORBY RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-2321
Practice Address - Country:US
Practice Address - Phone:636-938-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021008233363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner