Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | COA. 15769-NP | OH |
N | 363LA2100X | Nurse Practitioner - Acute Care | COA. 15769-NP | OH |
N | 363LA2200X | Nurse Practitioner - Adult Health | COA. 15769-NP | OH |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | COA. 15769-NP | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | COA. 15769-NP | OH |
NPI | 1184042764 |
---|---|
Provider Name | Jonathan David Easterling |
First Address | Cleveland, OH 44111-5612 |
Second Address | Cleveland, OH 44111-5612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 01/04/2014 |