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Individual

LARA JEAN EASTERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP-CNP

Contact information

Practice address
5101 W MEMORIAL RD, OKLAHOMA CITY, OK 73142-2018
(405) 752-9600
(405) 752-9650
Mailing address
PO BOX 268938, OKLAHOMA CITY, OK 73126-8938
(405) 752-9600
(405) 752-9650

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
76862
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200186830A
OK
Enumeration date
10/22/2007
Last updated
08/20/2014
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