Provider Demographics
NPI:1851986822
Name:EASTMAN, ASHLEY A (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5721 N ATHENIAN AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-1844
Mailing Address - Country:US
Mailing Address - Phone:316-722-2138
Mailing Address - Fax:800-764-6095
Practice Address - Street 1:7701 E KELLOGG DR STE 490
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1716
Practice Address - Country:US
Practice Address - Phone:316-722-2138
Practice Address - Fax:800-764-6095
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS5380044062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner