Provider Demographics
NPI:1336547793
Name:EASLEY, KATHERINE D (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:D
Last Name:EASLEY
Suffix:
Gender:F
Credentials: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 1:5501 NW 62ND TER STE 100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2412
Mailing Address - Country:US
Mailing Address - Phone:816-842-4440
Mailing Address - Fax:816-842-1974
Practice Address - Street 1:1133 W KANSAS ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-2281
Practice Address - Country:US
Practice Address - Phone:816-781-7400
Practice Address - Fax:816-781-3315
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76624-121363LF0000X
MO2022043258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily