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General NPI Number Information
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NPI Number | 1639485261
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Entity Type | Individual
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Provider Name | DONNA SAUNDERS EASTHAM
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Gender | Female
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 246 MARCELLUS DR
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City | BEREA
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State | KY
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Zip | 40403-2078
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Country | US
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Telephone | 859-626-2107
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Fax | 859-985-9401
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Provider Business Mailing Address
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Address Line | 246 MARCELLUS DRIVE
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City | BEREA
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State | KY
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Zip | 40403
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Country | US
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Telephone | 859-626-2107
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Fax | 859-985-9401
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 174400000X
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License Number State | KY
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