Healthcare Provider Details

I. General information

NPI: 1881050060
Provider Name (Legal Business Name): ANGELA S EASTERDAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 MERCY DR NW STE 200
CANTON OH
44708-2624
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 330-489-1065
  • Fax: 330-430-6957
Mailing address:
  • Phone: 330-489-1065
  • Fax: 330-430-6957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number18310-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: