Provider Demographics
NPI:1316203870
Name:EASTER, JESSICA DIXON
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DIXON
Last Name:EASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3562 PIN HOOK RD APT 1217
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2985
Mailing Address - Country:US
Mailing Address - Phone:615-434-4411
Mailing Address - Fax:
Practice Address - Street 1:3562 PIN HOOK RD APT 1217
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2985
Practice Address - Country:US
Practice Address - Phone:615-434-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula