Provider Demographics
NPI:1851000566
Name:EASTIN, HANNAH (RPH)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:EASTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:REWERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:712 S HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:BUCKNER
Mailing Address - State:MO
Mailing Address - Zip Code:64016-9508
Mailing Address - Country:US
Mailing Address - Phone:660-373-2405
Mailing Address - Fax:
Practice Address - Street 1:5310 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-3063
Practice Address - Country:US
Practice Address - Phone:816-313-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022029442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist