Provider Demographics
NPI:1871364018
Name:EASTERLIN, CLARA (PA-C)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:EASTERLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 CHARLOTTE PIKE STE 106
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4256
Mailing Address - Country:US
Mailing Address - Phone:615-224-2665
Mailing Address - Fax:
Practice Address - Street 1:6606 CHARLOTTE PIKE STE 106
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4256
Practice Address - Country:US
Practice Address - Phone:615-224-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5743363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty