Provider Demographics
NPI:1265073886
Name:EATMON, JULIA C
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:EATMON
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 1:2620 KINGSPORT HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-3562
Mailing Address - Country:US
Mailing Address - Phone:423-470-0328
Mailing Address - Fax:
Practice Address - Street 1:2620 KINGSPORT HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3562
Practice Address - Country:US
Practice Address - Phone:423-470-0328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider