Individual
KELLY S EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
231 GRANITE RUN DR, LANCASTER, PA 17601-6823
(717) 560-4200
(717) 560-4159
Mailing address
231 GRANITE RUN DR, LANCASTER, PA 17601-6823
(717) 560-4200
(717) 560-4159
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056608
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA056608
STATE LICENSE
PA
Enumeration date
10/03/2013
Last updated
06/11/2025
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