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Individual

MS. DIANE EASTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
RT. 6 TOWN PLAZA, SUITE 2, TUNKHANNOCK, PA 18657
(570) 836-4294
(570) 836-7709
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP008339
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02679252
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039862
MEDICARE GROUP
PA
01
P00362289
RR MEDICARE PIN
PA
Enumeration date
03/21/2006
Last updated
06/22/2011
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