Provider Demographics
NPI:1528635356
Name:EASTERDAY, LOGAN (MSN,APRN,AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:EASTERDAY
Suffix:
Gender:M
Credentials:MSN,APRN,AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 MALLORY LN STE 110
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8230
Mailing Address - Country:US
Mailing Address - Phone:615-771-3024
Mailing Address - Fax:615-771-3027
Practice Address - Street 1:1909 MALLORY LN STE 110
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8230
Practice Address - Country:US
Practice Address - Phone:157-713-0246
Practice Address - Fax:615-771-3027
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29612363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care