MEDICARE: AYLISH ANN EATON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1225738099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYLISH ANN EATON

Provider Business Mailing Address
First Line	:	207 S SUNSET DR
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-9525
Country	:	US
Telephone Number	:	208-619-9735
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 S SUNSET DR
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-9525
Country	:	US
Telephone Number	:	208-619-9735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	03/09/2023

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Directions to “ AYLISH ANN EATON ” Practice Location

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