Provider Demographics
NPI:1164861035
Name:EASTERLING, RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 E BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5226
Mailing Address - Country:US
Mailing Address - Phone:480-649-9000
Mailing Address - Fax:480-248-9213
Practice Address - Street 1:3100 N. ALMA SCHOOL RD
Practice Address - Street 2:MY DR NOW
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1468
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:480-677-8283
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5748363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care