Provider Demographics
NPI:1114475738
Name:EASTERLING, DELLA ANN (NP)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:ANN
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-3307
Mailing Address - Country:US
Mailing Address - Phone:276-325-0678
Mailing Address - Fax:866-521-2461
Practice Address - Street 1:DEPT 88163
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37995-0001
Practice Address - Country:US
Practice Address - Phone:276-325-0678
Practice Address - Fax:866-521-2461
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner