Provider Demographics
NPI:1942511423
Name:EATMAN, KELLI E (RRT)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:E
Last Name:EATMAN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SPRUCE MILL LN
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-3185
Mailing Address - Country:US
Mailing Address - Phone:732-895-1165
Mailing Address - Fax:
Practice Address - Street 1:152 SPRUCE MILL LN
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-3185
Practice Address - Country:US
Practice Address - Phone:732-895-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ432A00429400227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered