Provider Demographics
NPI:1659569689
Name:EASTMAN, DARLA KLUG (PHARMD)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:KLUG
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-6204
Mailing Address - Country:US
Mailing Address - Phone:515-991-1636
Mailing Address - Fax:
Practice Address - Street 1:2500 UNIVERSITY AVE
Practice Address - Street 2:DRAKE UNIVERSITY COLLEGE OF PHARMACY CLINE HALLE #219
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-4504
Practice Address - Country:US
Practice Address - Phone:515-271-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist