Healthcare Provider Details

I. General information

NPI: 1477967750
Provider Name (Legal Business Name): ILANA EASTMAN RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ILANA PARKER RN

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-6906
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR203326
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: