Individual
MRS. SHELBY MARIE EASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
11311 BRIDGEPORT WAY SW STE 207, LAKEWOOD, WA 98499-3051
(253) 272-8664
(253) 627-7880
Mailing address
6044 YOSEMITE DR, NEWBURGH, IN 47630-2005
(618) 335-1536
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP61526448
WA
363LF0000X
Family Nurse Practitioner
28251063C
IN
363LF0000X
Family Nurse Practitioner
Primary
AP61526448
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2280338
—
WA
Enumeration date
01/17/2024
Last updated
08/15/2024
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