Provider Demographics
NPI:1568544427
Name:EASON, LINDA FAYE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:FAYE
Last Name:EASON
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 1:7401 BLACKMON RD APT 116
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-7513
Mailing Address - Country:US
Mailing Address - Phone:706-545-0984
Mailing Address - Fax:706-545-4033
Practice Address - Street 1:6540 WAY AVE BLDG 2822
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-3799
Practice Address - Country:US
Practice Address - Phone:706-545-4033
Practice Address - Fax:706-545-3022
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37488163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse