Provider Demographics
NPI:1881050060
Name:EASTERDAY, ANGELA S (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:S
Last Name:EASTERDAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 951103
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0005
Mailing Address - Country:US
Mailing Address - Phone:330-489-1065
Mailing Address - Fax:330-430-6957
Practice Address - Street 1:1330 MERCY DR NW STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2624
Practice Address - Country:US
Practice Address - Phone:330-489-1065
Practice Address - Fax:330-430-6957
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18310-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner