Provider Demographics
NPI:1861948135
Name:EASH, JOANNE T (FNP-BC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:T
Last Name:EASH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 MARKETPLACE PKWY
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-7266
Mailing Address - Country:US
Mailing Address - Phone:678-389-6509
Mailing Address - Fax:
Practice Address - Street 1:378 MARKETPLACE PKWY
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-7266
Practice Address - Country:US
Practice Address - Phone:678-389-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN139412363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily