Provider Demographics
NPI:1700842150
Name:EASTWOOD, VERONICA C (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:C
Last Name:EASTWOOD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4586 ROYAL PORT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3213
Mailing Address - Country:US
Mailing Address - Phone:904-608-3562
Mailing Address - Fax:
Practice Address - Street 1:4586 ROYAL PORT DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-3213
Practice Address - Country:US
Practice Address - Phone:904-608-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3397792367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG3911OtherBLUE CROSS BLUE SHIELD
FL307508700Medicaid
GA102967541AMedicaid
FLG3911OtherBLUE CROSS BLUE SHIELD