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General NPI Number Information
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NPI Number | 1457290967
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Entity Type | Individual
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Provider Name | AMY EASTMAN RN
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Gender | Male
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 400 WATER AVE
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City | HILLSBORO
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State | WI
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Zip | 54634-9054
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Country | US
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Telephone | 608-489-8305
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Fax | 608-489-8194
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Provider Business Mailing Address
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Address Line | W7337 GEIER RD
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City | WONEWOC
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State | WI
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Zip | 53968-9768
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Country | US
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Telephone | 608-489-8305
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Fax | 608-489-8194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX1500X
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Taxonomy Name | Ostomy Care Registered Nurse
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License Number | 133155030
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 133155-030
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License Number State | WI
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