MEDICARE: CHRISTOPHER JAMES EASTON PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0032446	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	112476	WV
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3018483	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0032446	OTHER	OH	OH NP
2	3018483	OTHER	KY	KY NP
3	112476	OTHER	WV	WV NP LICENSE

General Provider Information

NPI Number	:	1629785175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES EASTON PMHNP-BC

Provider Business Mailing Address
First Line	:	1 KENTON DR STE 200
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25311-1256
Country	:	US
Telephone Number	:	681-243-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 KENTON DR
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25311-1256
Country	:	US
Telephone Number	:	681-243-9066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	01/10/2026

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