Provider Demographics
NPI:1831226414
Name:EATON-HILL, CATHY SUE (ARNP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SUE
Last Name:EATON-HILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VONDERBURG DR STE 102E
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5968
Mailing Address - Country:US
Mailing Address - Phone:813-681-5658
Mailing Address - Fax:813-681-5250
Practice Address - Street 1:500 VONDERBURG DR STE 102E
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-681-5658
Practice Address - Fax:813-681-5250
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9484884363LP2300X
GARN076736NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA762424450AMedicaid
50BBHWVMedicare ID - Type Unspecified