Individual
MR. ROBERT EASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(803) 370-1644
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(803) 370-1644
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169823
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024169823
LICENSE
VA
Enumeration date
01/19/2012
Last updated
10/27/2020
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