Provider Demographics
NPI:1487898128
Name:EAST, DEIRDRE ELAINE (CNM)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:ELAINE
Last Name:EAST
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 N ACACIA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2450
Mailing Address - Country:US
Mailing Address - Phone:559-638-8187
Mailing Address - Fax:559-638-3883
Practice Address - Street 1:1415 N ACACIA AVE STE 101
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2450
Practice Address - Country:US
Practice Address - Phone:559-638-8187
Practice Address - Fax:559-638-3883
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549823163WM0102X
CA1849367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn