Provider Demographics
NPI:1396348066
Name:EASH, SANDRA SUE
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SUE
Last Name:EASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 NAVARRE RD SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9459
Mailing Address - Country:US
Mailing Address - Phone:330-327-1554
Mailing Address - Fax:
Practice Address - Street 1:6919 NAVARRE RD SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9459
Practice Address - Country:US
Practice Address - Phone:330-327-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion