Basic Information
| Provider Information | |||||||||
| NPI: | 1487898128 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EAST | ||||||||
| FirstName: | DEIRDRE | ||||||||
| MiddleName: | ELAINE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | C.N.M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1415 N ACACIA AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | REEDLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936542450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596388187 | ||||||||
| FaxNumber: | 5596383883 | ||||||||
| Practice Location | |||||||||
| Address1: | 1415 N ACACIA AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | REEDLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936542450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596388187 | ||||||||
| FaxNumber: | 5596383883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2009 | ||||||||
| LastUpdateDate: | 04/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0102X | 549823 | CA | N | Nursing Service Providers | Registered Nurse | Maternal Newborn | 367A00000X | 1849 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.