Provider Demographics
NPI:1033911334
Name:EASTERLING, SHAUNA E (PRS)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:E
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4069 BRADLEY CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2565
Mailing Address - Country:US
Mailing Address - Phone:866-835-1364
Mailing Address - Fax:330-409-9081
Practice Address - Street 1:4069 BRADLEY CIR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2565
Practice Address - Country:US
Practice Address - Phone:866-835-1364
Practice Address - Fax:330-409-9081
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.006212175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist