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Individual

PATRICIA D EATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, AGNP,PMHNP

Contact information

Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(417) 761-5011

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2009029316
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2016017853
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420032576
MO
Enumeration date
05/11/2016
Last updated
01/13/2021
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