Provider Demographics
NPI:1073577151
Name:EASTER, CYNTHIA (CNS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:EASTER
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-8752
Mailing Address - Fax:
Practice Address - Street 1:601 S 169 HWY
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089
Practice Address - Country:US
Practice Address - Phone:816-532-3700
Practice Address - Fax:816-532-7163
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN061005163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25047013OtherBCBSKC
MO425106200Medicaid
MO5509262Medicare ID - Type Unspecified
MO890000209Medicare ID - Type UnspecifiedMEDICARE RAILROAD