Provider Demographics
NPI:1336547793
Name:EASLEY, KATHERINE D (APRN, MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:D
Last Name:EASLEY
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:KAT
Other - Middle Name:D
Other - Last Name:EASLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, MSN, FNP-C
Mailing Address - Street 1:16575 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7770
Mailing Address - Country:US
Mailing Address - Phone:913-815-5508
Mailing Address - Fax:855-446-7281
Practice Address - Street 1:16575 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7770
Practice Address - Country:US
Practice Address - Phone:913-815-5508
Practice Address - Fax:855-446-7281
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76624-121363LF0000X
MO2015040088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily