Healthcare Provider Details

I. General information

NPI: 1073436598
Provider Name (Legal Business Name): ISIS KEYONA EATON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 JORDAN HOUSE DR
SMITHFIELD VA
23430-6390
US

IV. Provider business mailing address

204 JORDAN HOUSE DR
SMITHFIELD VA
23430-6390
US

V. Phone/Fax

Practice location:
  • Phone: 757-746-3672
  • Fax:
Mailing address:
  • Phone: 757-746-3672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026004723
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: