Healthcare Provider Details

I. General information

NPI: 1891760948
Provider Name (Legal Business Name): ELIZABETH EASLEY APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9239 W CENTER RD SUITE 222
OMAHA NE
68124
US

IV. Provider business mailing address

9239 W CENTER RD SUITE 222
OMAHA NE
68124
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-8035
  • Fax: 402-354-8044
Mailing address:
  • Phone: 402-354-8035
  • Fax: 402-354-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number110089
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number28778
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: