Individual
MS. NANCY M EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4622 40TH AVE S, FARGO, ND 58104-4394
(701) 364-2909
(701) 364-9346
Mailing address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161
(701) 234-6161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9637
MN
363A00000X
Physician Assistant
PAC0342
ND
Other
Enumeration date
12/13/2006
Last updated
01/08/2011
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