Provider Demographics
NPI:1770935652
Name:EASTMAN, JESSICA (ARNP, CPNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:ARNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 US HIGHWAY 301 N
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-8672
Mailing Address - Country:US
Mailing Address - Phone:941-723-7877
Mailing Address - Fax:941-723-7844
Practice Address - Street 1:8425 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8672
Practice Address - Country:US
Practice Address - Phone:941-723-7877
Practice Address - Fax:941-723-7844
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9222499363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics