Provider Demographics
NPI:1225470859
Name:EASTMAN, LAURA LOPEZ (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LOPEZ
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3742 WINTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-9230
Mailing Address - Country:US
Mailing Address - Phone:804-330-3335
Mailing Address - Fax:804-330-9205
Practice Address - Street 1:3742 WINTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9230
Practice Address - Country:US
Practice Address - Phone:804-330-3335
Practice Address - Fax:804-330-9205
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily