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General NPI Number Information
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NPI Number | 1891576609
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Entity Type | Individual
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Provider Name | GINU EASOW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1573 W FAIRBANKS AVE STE 100
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City | WINTER PARK
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State | FL
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Zip | 32789-4679
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Country | US
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Telephone | 407-896-8097
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Fax | 407-898-8328
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Provider Business Mailing Address
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Address Line | 2697 LEGACY RESERVE CT
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City | WINTER PARK
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State | FL
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Zip | 32792-7521
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Country | US
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Telephone | 407-743-9113
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11029060
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License Number State | FL
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