Healthcare Provider Details

I. General information

NPI: 1336547793
Provider Name (Legal Business Name): KATHERINE D EASLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAT D EASLEY APRN, MSN, FNP-C

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 W KANSAS ST
LIBERTY MO
64068-2281
US

IV. Provider business mailing address

5501 NW 62ND TER STE 100
KANSAS CITY MO
64151-2412
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-7400
  • Fax: 816-781-3315
Mailing address:
  • Phone: 816-842-4440
  • Fax: 816-842-1974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76624-121
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022043258
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: