NPI 1629477633

Blanche Eaton

Practitioner Preferred Provider Organization Minneapolis, MN

Practice location

Address: 1502 W Broadway Ave, Minneapolis, MN 55411-2408
Phone: (612) 529-2399
Fax: (612) 529-2399

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 3675466 (MN)

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Registry record

NPI: 1629477633
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Aug 2014
Record last updated: 14 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.