Provider Demographics
NPI:1245011923
Name:RICH, EASTON DANIELLE (APRN)
Entity type:Individual
Prefix:
First Name:EASTON
Middle Name:DANIELLE
Last Name:RICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EASTON
Other - Middle Name:DANIELLE
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:1175 VINE ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-3526
Practice Address - Country:US
Practice Address - Phone:870-793-4600
Practice Address - Fax:870-793-4608
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR226344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily