Provider Demographics
NPI:1053913160
Name:EASTERWOOD, RACHEL STUCKEY (WHNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:STUCKEY
Last Name:EASTERWOOD
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W WAUGH ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3116
Mailing Address - Country:US
Mailing Address - Phone:706-529-8076
Mailing Address - Fax:706-529-8081
Practice Address - Street 1:303 W WAUGH ST
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3116
Practice Address - Country:US
Practice Address - Phone:706-529-8076
Practice Address - Fax:706-529-8081
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28536363LW0102X
GARN248691363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health