Provider Demographics
NPI:1619541067
Name:EASTMAN, ABBY M (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:M
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16488 REDINGTON DR
Mailing Address - Street 2:
Mailing Address - City:REDINGTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1550
Mailing Address - Country:US
Mailing Address - Phone:913-850-8292
Mailing Address - Fax:
Practice Address - Street 1:16488 REDINGTON DR
Practice Address - Street 2:
Practice Address - City:REDINGTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33708-1550
Practice Address - Country:US
Practice Address - Phone:913-850-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date: