Individual
SUSAN EASTABROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
9485 MENTOR AVE STE 210, PRIMEHEALTH, MENTOR, OH 44060-8723
(440) 205-5833
Mailing address
PO BOX 5076, MENTOR, OH 44061-5076
(440) 209-8590
(440) 209-8590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-09641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2797853
—
OH
01
—
P00626775
MEDICARE RAILROAD PIN
OH
Enumeration date
11/19/2007
Last updated
09/18/2015
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