KELLY EATON (NPI# 1255799565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255799565 |
| Entity Type | Individual |
| Full Name | KELLY EATON |
| Practice Address |
1015 S Broadway Suite 18 Minot ND 58701-4667 |
| Practice Telephone | 7018578500 |
| Practice Fax Number | 7018578555 |
| Mailing Telephone | 7018578500 |
| Mailing Fax Number | 7018578555 |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | L14546 | ND | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144687658 | Kelly A. Eaton | Audiologist | 10475 Centurion Pkwy N Ste 300, Jacksonville, FL 32256-5004 | 2016-01-28 |
| 1972878908 | Kelly Ann Eaton | Chiropractor | 5103 Merriam Dr, Merriam, KS 66203-2167 | 2012-03-08 |
| 1487082376 | Kelly Eaton | Physical Therapist | 17 Chipman Way, Kingston, MA 02364-1039 | 2013-10-31 |
| 1447687561 | Kelly S Eaton | Physician Assistant | 11 Fairlane Rd, Reading, PA 19606-9567 | 2013-10-03 |
| Street Address |
1015 S BROADWAY SUITE 18 |
| City | MINOT |
| State | ND |
| Zip Code | 58701-4667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548200892 | Tim Scott Carlson | Pharmacist | 1015 S Broadway, Ste. #3, Minot, ND 58701-4667 | 2006-06-07 |
| 1831748151 | Elizabeth Ann Vibeto | Registered Nurse | 1015 S Broadway, Minot, ND 58701-4667 | 2019-09-09 |
| 1538693973 | Morgan Bright | Case Manager/Care Coordinator | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2017-04-12 |
| 1932631280 | Ness Family Dentistry, LLC | Clinic/Center | 1015 S Broadway, Suite 20, Minot, ND 58701-4667 | 2017-03-28 |
| 1679004899 | Onyinye Okoye-epundu | Registered Nurse | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2017-03-21 |
| 1508301292 | Stacey Jackson | Registered Nurse | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2017-01-04 |
| 1568906949 | Kimberly Luster | Registered Nurse | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2016-12-05 |
| 1992248819 | Emmanuel Toquee | Case Manager/Care Coordinator | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2016-11-25 |
| 1366992661 | Shari Pister | Case Manager/Care Coordinator | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2016-10-11 |
| 1770032112 | Janelle Mellor | Case Manager/Care Coordinator | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2016-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767926 | Minot Commission On Aging, Inc | In Home Supportive Care | 21 1st Avenue Se, Minot, ND 58701 | 2020-10-16 |
| 1780207647 | Growing Together Inc | Counselor | 515 19 Ave Sw, Minot, ND 58701 | 2020-05-26 |
| 1144867847 | Sarah Howard | Registered Nurse | 1015 South Broadway, Ste. 2, Minot, ND 58701 | 2019-12-02 |
| 1962973453 | Julia Irene Lakoduk | Speech-Language Pathologist | Bell Elementary, 5901 Us-52, Minot, ND 58701 | 2018-12-10 |
| 1073000469 | Goodman Addiction Services | Counselor | 1809 South Broadway Suite S., Minot, ND 58701 | 2018-04-20 |
| 1811405988 | Mackenzie J Jones Pllc | Chiropractor | 1407 S Broadway Ste 123, Minot, ND 58701 | 2018-01-11 |
| 1265957617 | Cassandra Czerwonka | Behavioral Analyst | 1408 20th Ave Sw, Suite 7, Minot, ND 58701 | 2017-08-07 |
| 1689197493 | Rem North Dakota | Intermediate Care Facility, Mentally Retarded | 1905 2nd Street Se, Suite 1a, Minot, ND 58701 | 2017-07-24 |
| 1558890236 | Timothy J Corrigan | Chiropractor | 1418 S Broadway Ste C, Minot, ND 58701 | 2017-06-07 |
| 1265826036 | Premier Physical Therapy of North Dakota Pllc | Physical Therapist | 1715 South Broadway, Minot, ND 58701 | 2015-03-19 |
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| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386064780 | Desiree Avedon Aaron-barber | Licensed Practical Nurse | Minot Va Cboc, Minot Air Force Base, Minot, ND 58705 | 2014-04-24 |
| 1427148113 | Linette Fay Hjelden | Licensed Practical Nurse | 1015 S Broadway Ste 18, Minot, ND 58701-4667 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977983 | Brooke Thomson | Licensed Practical Nurse | 901 28th St S Ste C, Fargo, ND 58103-8745 | 2020-09-21 |
| 1891246112 | Winona Clarice Kitzan | Licensed Practical Nurse | 1141 W Owens Ave, Apt 107, Bismarck, ND 58501-1333 | 2016-10-21 |
| 1003367665 | Sara Froelich | Licensed Practical Nurse | N 10 River Rd, Fort Yates, ND 58538 | 2016-10-19 |
| 1205246725 | Adriana Dean | Licensed Practical Nurse | 3560 Highway 1806, Mandan, ND 58554-8241 | 2014-05-06 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| 1396176517 | Nicole Syverson | Licensed Practical Nurse | 521 3rd Ave, Reynold, ND 58275 | 2013-12-13 |
| 1922343631 | Sharon A Wolf | Licensed Practical Nurse | 200 Hwy 2 West, Lake Region Human Service Center, Devils Lake, ND 58301-0650 | 2012-12-06 |
| 1619583929 | Alfahnique C Teigen | Licensed Practical Nurse | 1463 I94 Business Loop E, Dickinson, ND 58601-6434 | 2020-09-22 |
| 1871115683 | Jorden Moe | Licensed Practical Nurse | 1200 Collins Ave, Mandan, ND 58554-2066 | 2020-05-14 |
| 1285253302 | Deborah England | Licensed Practical Nurse | 1200 Collins Ave, Mandan, ND 58554-2066 | 2020-04-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.