Provider Demographics
NPI:1427845155
Name:EAZY IV, LLC
Entity type:Organization
Organization Name:EAZY IV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NURSE PRACTICTIONER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAFKA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:937-416-4738
Mailing Address - Street 1:4238 BELLE TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8242
Mailing Address - Country:US
Mailing Address - Phone:937-416-4738
Mailing Address - Fax:
Practice Address - Street 1:4238 BELLE TERRACE LN
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8242
Practice Address - Country:US
Practice Address - Phone:937-416-4738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy