Provider Demographics
NPI:1457761611
Name:EASTER, SABRINA GAIL (APRN)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:GAIL
Last Name:EASTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:TUTWILER
Mailing Address - State:MS
Mailing Address - Zip Code:38963-5067
Mailing Address - Country:US
Mailing Address - Phone:662-345-8334
Mailing Address - Fax:
Practice Address - Street 1:205 ALMA ST
Practice Address - Street 2:
Practice Address - City:TUTWILER
Practice Address - State:MS
Practice Address - Zip Code:38963-5067
Practice Address - Country:US
Practice Address - Phone:662-345-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872546363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care