SHANNON MICHELLE EATON MSN FPMHNP PMHNP NPI 1124519822

NPI Information

NPI: 1124519822
Provider Name: SHANNON MICHELLE EATON, MSN, FPMHNP, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: VALDEZ AND SOTO LLC

PECOS Registration: Yes

Address:
1300 E BRADFORD PKWY
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 761-5000
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Shannon Michelle Eaton, MSN, FPMHNP, PMHNP is a psychiatric/mental health nurse practitioner in Springfield, MO with 6 years of experience. Shannon Michelle Eaton, MSN, FPMHNP, PMHNP NPI is 1124519822. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1300 E BRADFORD PKWY
SPRINGFIELD, MO
ZIP 65804-264
Phone: (417) 761-5000
Fax: (417) 761-5065

The NPI 1124519822 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/29/2018 and was last updated on 11/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		138149	MISSOURI	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	2018024368	MISSOURI	Yes
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	10504	WISCONSIN	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	420056428	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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