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General NPI Number Information
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NPI Number | 1568328714
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Entity Type | Individual
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Provider Name | JAMIE ANN EASTON AAS HEALTH WELLNESS
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Gender | Female
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1730 63RD CT APT 304
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City | KENOSHA
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State | WI
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Zip | 53144-5626
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Country | US
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Telephone | 847-791-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 63RD CT APT 304
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City | KENOSHA
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State | WI
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Zip | 53144-5626
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Country | US
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Telephone | 847-791-0360
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Fax |
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | WI
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