Provider Demographics
NPI:1629969217
Name:EATON, RACHAEL ANNA (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ANNA
Last Name:EATON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ANNA
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2012 BUTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5638
Mailing Address - Country:US
Mailing Address - Phone:618-581-8555
Mailing Address - Fax:
Practice Address - Street 1:12545 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6311
Practice Address - Country:US
Practice Address - Phone:314-786-5389
Practice Address - Fax:314-786-5389
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014002257363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner