Provider Demographics
NPI:1992148514
Name:EASON, MARCIA ROSELLA (LPN)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:ROSELLA
Last Name:EASON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25200 ROCKSIDE RD APT 530
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1921
Mailing Address - Country:US
Mailing Address - Phone:216-738-9881
Mailing Address - Fax:216-255-9755
Practice Address - Street 1:25200 ROCKSIDE RD APT 530
Practice Address - Street 2:
Practice Address - City:BEDFORD HTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1921
Practice Address - Country:US
Practice Address - Phone:216-738-9881
Practice Address - Fax:216-255-9755
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2014-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151758164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse