Provider Demographics
NPI:1467797977
Name:EASTER, JAMES ALAN (NP-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
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 1:400 S CHESTNUT ST OFC
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-3335
Mailing Address - Country:US
Mailing Address - Phone:662-369-2040
Mailing Address - Fax:928-283-2677
Practice Address - Street 1:400 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-3335
Practice Address - Country:US
Practice Address - Phone:662-369-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner