Amanda Courtney Easterling, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P323190 Issued in MS

Practice address

509 Bassfield Cemetery Rd
Bassfield, MS 39421-8906

Phone

(228) 254-0976

NPI assigned

Jul 22, 2022

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iconic Homecare LLC

  • Home Health Agency
  • Bassfield, MS
  • NPI 1760258909
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2022.

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1083349062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 BASSFIELD CEMETERY RD",
            "city": "BASSFIELD",
            "state": "MS",
            "postal_code": "394218906",
            "telephone_number": "228-254-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 BASSFIELD CEMETERY RD",
            "city": "BASSFIELD",
            "state": "MS",
            "postal_code": "394218906",
            "telephone_number": "228-254-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "AMANDA",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P323190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Companion at Home LLC
• Robert H Carr, RPH
• Chloe Elayne Crittenden, COTA
• Express Care Transportation LLC
• Family Health Care Clinic, Inc.
• Randy S Hathorn, DMD
• Iconic Homecare LLC
• Kingdom Home Care and Nursing Services LLC

• All providers in Bassfield, MS
• Licensed Practical Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.