Individual
JOSEPH LEE EASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
1275 HAWTHORN RD, SALEM, IL 62881-1028
(618) 548-4590
(618) 548-8275
Mailing address
1275 HAWTHORN RD, SALEM, IL 62881-1028
(618) 548-4590
(618) 548-8275
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN28947
MT
Other
Enumeration date
09/21/2005
Last updated
10/11/2012
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