Individual
AUDREY LYNN EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1075 CAMINO DEL RIO S, SAN DIEGO, CA 92108-3538
(619) 881-4500
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-5000
(619) 532-6950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
18489
CA
363LF0000X
Family Nurse Practitioner
Primary
18489
CA
Other
Enumeration date
02/04/2009
Last updated
12/01/2021
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