Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | A1007323 | OH |
NPI | 1023276326 |
---|---|
Provider Name | Mrs. Stephanie E. Eastek |
First Address | Youngstown, OH 44505-2144 |
Second Address | Youngstown, OH 44505-2144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 23/05/2008 |