Healthcare Provider Details

I. General information

NPI: 1316860612
Provider Name (Legal Business Name): AMBER EASTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 SUNDANCE AVE
EVANSTON WY
82930-9107
US

IV. Provider business mailing address

855 SUNDANCE AVE
EVANSTON WY
82930-9107
US

V. Phone/Fax

Practice location:
  • Phone: 307-679-8287
  • Fax:
Mailing address:
  • Phone: 307-679-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SH1100X
TaxonomyHolistic Clinical Nurse Specialist
License Number49951
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: