Provider Demographics
NPI:1053816025
Name:EATON, LATONIA RENELL
Entity Type:Individual
Prefix:MRS
First Name:LATONIA
Middle Name:RENELL
Last Name:EATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 VOORHEIS ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1947
Mailing Address - Country:US
Mailing Address - Phone:313-960-0814
Mailing Address - Fax:
Practice Address - Street 1:338 VOORHEIS ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1947
Practice Address - Country:US
Practice Address - Phone:313-960-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide