Provider Demographics
NPI:1346937083
Name:EATON, MARILYN J
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:J
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 1:47 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44847-9456
Mailing Address - Country:US
Mailing Address - Phone:419-681-3190
Mailing Address - Fax:
Practice Address - Street 1:47 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44847-9456
Practice Address - Country:US
Practice Address - Phone:419-681-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemaker