Kelly Jo Easley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010029A Issued in IN

Practice address

2701 E 3Rd St
Bloomington, IN 47401-5433

Phone

(812) 332-1419

NPI assigned

May 9, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588982400000",
    "number": "1487276739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 S BRAND LEE WAY",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853655110",
            "telephone_number": "740-260-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E 3RD ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015433",
            "telephone_number": "812-332-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-09",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010029A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Earhart
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• William Wade Earls, M.A.
• Eartheart LLC
• Bret Davis Eartheart, MSW, LCSW
• East West Accupunture, Inc.
• Kevin East, PHARMD
• Tori J Eastes
• Elysia Easton
• Rebecca D. Eberle, M.A., CCC-SLP, BC-NC

• Family Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2020; 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.