Provider Demographics
NPI:1407277015
Name:EASLEY, SHAWNII (LPN)
Entity Type:Individual
Prefix:
First Name:SHAWNII
Middle Name:
Last Name:EASLEY
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 1:2408 GILHAM RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-1619
Mailing Address - Country:US
Mailing Address - Phone:503-360-3013
Mailing Address - Fax:
Practice Address - Street 1:2360 CHAMBERS STREET
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3910
Practice Address - Country:US
Practice Address - Phone:541-687-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201393674LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse