Provider Demographics
NPI:1265504138
Name:EATON, KATHERINE CELIA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:CELIA
Last Name:EATON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:CELIA
Other - Last Name:SPRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:412 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2947
Mailing Address - Country:US
Mailing Address - Phone:641-753-4021
Mailing Address - Fax:
Practice Address - Street 1:412 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2947
Practice Address - Country:US
Practice Address - Phone:641-753-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-079126363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP15840Medicare UPIN