Individual
LAURA EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Mailing address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
57106
ID
Other
Enumeration date
10/12/2017
Last updated
02/21/2020
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