Provider Demographics
NPI:1336474659
Name:EASTER, DARLA D (NP-C)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:D
Last Name:EASTER
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 MCCLELLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1640
Mailing Address - Country:US
Mailing Address - Phone:417-781-2807
Mailing Address - Fax:417-781-3309
Practice Address - Street 1:3105 MCCLELLAND BLVD
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1640
Practice Address - Country:US
Practice Address - Phone:417-781-2807
Practice Address - Fax:417-781-3309
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO132761363L00000X
MOF0809441363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner