Provider Demographics
NPI:1861660458
Name:EASTER, ELKA W (CNM)
Entity Type:Individual
Prefix:
First Name:ELKA
Middle Name:W
Last Name:EASTER
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:5619-25 VINE STREET
Mailing Address - Street 2:SPECTRUM HEALTH SERVICES, INC.
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-1302
Mailing Address - Country:US
Mailing Address - Phone:215-471-2761
Mailing Address - Fax:215-471-2929
Practice Address - Street 1:1415 NORTH BROAD STREET, SUITE 224
Practice Address - Street 2:BROAD STREET HEALTH CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3323
Practice Address - Country:US
Practice Address - Phone:215-235-7944
Practice Address - Fax:215-235-3361
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2013-07-22
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Provider Licenses
StateLicense IDTaxonomies
PAMW010167367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102133152Medicaid