Provider Demographics
NPI:1780362707
Name:EASTERLING, KARIN AUDRA (CPNP-PC)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:AUDRA
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 OCEAN SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1453
Mailing Address - Country:US
Mailing Address - Phone:757-580-7396
Mailing Address - Fax:
Practice Address - Street 1:2021 CONCERT DR STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-8082
Practice Address - Country:US
Practice Address - Phone:757-668-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187504363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics