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General NPI Number Information
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NPI Number | 1922311620
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Entity Type | Individual
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Provider Name | MARTHA A EASTMAN NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 268 STILLWATER AVENUE ACADIA HOSPITAL CORP.
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City | BANGOR
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State | ME
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Zip | 04401-0000
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Country | US
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Telephone | 207-973-6470
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Fax | 207-973-6109
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Provider Business Mailing Address
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Address Line | PO BOX 422 ACADIA HOSPITAL CORP.
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City | BANGOR
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State | ME
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Zip | 04402-0422
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Country | US
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Telephone | 207-973-6470
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Fax | 207-973-6109
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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 | AP101030
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License Number State | ME
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