Provider Demographics
NPI:1134192933
Name:EATON, PETER DAVID (CRNA)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:DAVID
Last Name:EATON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 HANS HERR DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9537
Mailing Address - Country:US
Mailing Address - Phone:717-464-3260
Mailing Address - Fax:
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 323
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-544-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN335386L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2349828000OtherINDEPENDENCE BLUE CROSS
PA50055758OtherKEYSTONE HEALTH PLAN CENTRAL
PA106584OtherGEISINGER
PA50055758OtherCAPITAL BLUE CROSS
PA7226773OtherAETNA-NON HMO
PAP00229597OtherRR MEDICARE
PA1147567OtherAETNA-HMO
PA001675112OtherHIGHMARK
PA50055758OtherKEYSTONE HEALTH PLAN CENTRAL