Provider Demographics
NPI:1538900337
Name:EATON, REBECCA RACHEL
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RACHEL
Last Name:EATON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:R
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHNP CNM DNP
Mailing Address - Street 1:13869 S CORA B LN
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6940
Mailing Address - Country:US
Mailing Address - Phone:801-889-0670
Mailing Address - Fax:
Practice Address - Street 1:1721 E CAMPUS CENTER DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-8914
Practice Address - Country:US
Practice Address - Phone:801-889-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT338773-3102163W00000X, 207V00000X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163W00000XNursing Service ProvidersRegistered Nurse
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT338773-3102OtherDOPL