Individual provider Active NPI

Jerrie Lynne Easterly, RN, BSN

  • Registered Nurse
  • Frisco, CO
National Provider Identifier
1669669529
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
86832 Issued in CO
Practice address
360 Peak One Drive
Frisco, CO 80443-2280
Phone
(970) 668-9714
Fax
(970) 668-4115
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 86832 CO Primary

Addresses

Primary practice location

360 Peak One Drive
Frisco, CO 80443-2280

Mailing address

PO Box 2280
Frisco, CO 80443-2280
Phone (970) 668-9714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
86832COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Summit County Government Registered Nurse Past Accepting new patients
Summit County Public Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1669669529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2280",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804432280",
            "telephone_number": "970-668-9714",
            "fax_number": "970-668-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DRIVE",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804432280",
            "telephone_number": "970-668-9714",
            "fax_number": "970-668-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLY",
        "first_name": "JERRIE",
        "middle_name": "LYNNE",
        "credential": "RN,  BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "86832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.