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Individual

STACY MARIE EATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP

Contact information

Practice address
1315 JESSE JEWELL PKWY NE STE 300, GAINESVILLE, GA 30501-3822
(770) 848-7246
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
RN205801
GA
363LA2200X
Adult Health Nurse Practitioner
RN205801
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN205801
GA
364SA2200X
Adult Health Clinical Nurse Specialist
RN205801
GA

Other

Enumeration date
01/21/2016
Last updated
01/07/2021
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