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General NPI Number Information
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NPI Number | 1164617775
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Entity Type | Individual
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Provider Name | BENNA L EASTER ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 802 ACKERLY ST
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City | LAMONI
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State | IA
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Zip | 50140-1544
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Country | US
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Telephone | 641-784-3371
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Fax | 641-784-6162
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Provider Business Mailing Address
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Address Line | 1404 NW CHURCH ST
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City | LEON
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State | IA
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Zip | 50144-1266
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Country | US
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Telephone | 641-446-4863
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Fax | 641-446-3576
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A-054747
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License Number State | IA
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