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General NPI Number Information
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NPI Number | 1376788364
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Entity Type | Individual
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Provider Name | MARIA A EASTMAN CRNP MSN NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/05/2008
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Last Update Date | 12/05/2008
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Provider Practice Location Address
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Address Line | 575 N RIVER ST
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City | WILKES BARRE
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State | PA
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Zip | 18764-0999
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Country | US
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Telephone | 570-552-7260
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Fax | 570-552-7268
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Provider Business Mailing Address
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Address Line | RR 3 BOX 280A
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City | MESHOPPEN
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State | PA
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Zip | 18630-9293
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Country | US
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Telephone | 570-833-5711
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Fax | 570-833-5711
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | VP005672B
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License Number State | PA
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