Provider Demographics
NPI:1144491226
Name:PERSON, EASTER ANNETTE
Entity type:Individual
Prefix:MRS
First Name:EASTER
Middle Name:ANNETTE
Last Name:PERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:EASTER
Other - Middle Name:ANNETTE
Other - Last Name:PERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20 CARRINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-1364
Mailing Address - Country:US
Mailing Address - Phone:770-787-2180
Mailing Address - Fax:
Practice Address - Street 1:20 CARRINGTON CIR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-1364
Practice Address - Country:US
Practice Address - Phone:770-787-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor