Individual
MERINDA HAIRSTON EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
755 LAUREL PARK AVE, MARTINSVILLE, VA 24112-0253
(276) 632-8612
(276) 632-8712
Mailing address
PO BOX 3085, MARTINSVILLE, VA 24115-3085
(276) 632-8612
(276) 632-8712
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163720136
—
VA
Enumeration date
10/10/2011
Last updated
10/10/2011
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