1801860507 NPI number — MARGARET ANN EASLEY RN MSN FNP

Table of content: MARGARET ANN EASLEY RN MSN FNP (NPI 1801860507)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801860507 NPI number — MARGARET ANN EASLEY RN MSN FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EASLEY
Provider First Name:
MARGARET
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN MSN FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801860507
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 BUENA VISTA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANDER
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82520-3447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-332-3050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
930 BUENA VISTA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANDER
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82520-3447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-332-3050
Provider Business Practice Location Address Fax Number:
307-332-3211
Provider Enumeration Date:
02/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  7337 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 105452 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 301055 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 301055 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 32683.1268 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 32683.1268 . This is a "WYOMING APN LIC" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: 0220844-22 . This is a "ANCC FNP CERIFICATION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 930MAE13 . This is a "WYOMING CONTROLLED SUBSTANCE REGISTRATION" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: F0395047 . This is a "AANP FNP CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10542 . This is a "RN RXN NP LIC" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 31358071 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 136461800 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7337 . This is a "NP FURNISHING NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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