Provider Demographics
NPI:1376068387
Name:EATON, AIMEE CHRISTA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:CHRISTA
Last Name:EATON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 CHILD RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06281-1599
Mailing Address - Country:US
Mailing Address - Phone:860-933-6742
Mailing Address - Fax:
Practice Address - Street 1:584 NORWICH RD STE 300
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1727
Practice Address - Country:US
Practice Address - Phone:860-230-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily