Healthcare Provider Details

I. General information

NPI: 1851986822
Provider Name (Legal Business Name): ASHLEY A EASTMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N WACO ST STE 220
WICHITA KS
67202-1102
US

IV. Provider business mailing address

245 N WACO ST STE 220
WICHITA KS
67202-1102
US

V. Phone/Fax

Practice location:
  • Phone: 316-722-2138
  • Fax: 833-464-2530
Mailing address:
  • Phone: 316-722-2138
  • Fax: 833-464-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberW11140
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5380044062
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: