Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 795171 | TX |
NPI | 1023148418 |
---|---|
Provider Name | Mrs. Liane Alane Eastman |
First Address | Austin, TX 78723-1142 |
Second Address | Austin, TX 78748-6208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 27/01/2022 |