Provider Demographics
NPI:1801860507
Name:EASLEY, MARGARET ANN (RN MSN FNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:EASLEY
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-3447
Mailing Address - Country:US
Mailing Address - Phone:307-332-3050
Mailing Address - Fax:
Practice Address - Street 1:930 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3447
Practice Address - Country:US
Practice Address - Phone:307-332-3050
Practice Address - Fax:307-332-3211
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7337363LF0000X
CO105452363LF0000X
CA301055363LP2300X, 363LF0000X
WY32683.1268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY32683.1268OtherWYOMING APN LIC
CA0220844-22OtherANCC FNP CERIFICATION
WY930MAE13OtherWYOMING CONTROLLED SUBSTANCE REGISTRATION
F0395047OtherAANP FNP CERTIFICATION
CO10542OtherRN RXN NP LIC
CO31358071Medicaid
WY136461800Medicaid
CA7337OtherNP FURNISHING NUMBER
CA7337OtherNP FURNISHING NUMBER
COP08152Medicare UPIN