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Individual

MICHAEL RAY EATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-7273
(816) 271-7376
Mailing address
7001 BLUE RIDGE BLVD, RAYTOWN, MO 64133-5629
(913) 980-3571

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
14-121479-102
KS
163WE0003X
Emergency Registered Nurse
2007033208
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2015002160
MO

Other

Enumeration date
01/21/2015
Last updated
02/15/2022
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