Provider Demographics
NPI:1629762018
Name:EASTMAN, SANTANA LYN (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANTANA
Middle Name:LYN
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 US ROUTE 212
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:ME
Mailing Address - Zip Code:04780-4101
Mailing Address - Country:US
Mailing Address - Phone:207-256-0705
Mailing Address - Fax:
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:ME
Practice Address - Zip Code:04068-3527
Practice Address - Country:US
Practice Address - Phone:207-625-8126
Practice Address - Fax:207-625-2595
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN68338163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse