Individual
JACLYN LEE EASTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14099 PINE LODGE LN, FORT MYERS, FL 33913-9470
(774) 266-3419
Mailing address
14099 PINE LODGE LN, FORT MYERS, FL 33913-9470
(774) 266-3419
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11037853
FL
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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