Active NPI
Kristina Easley
- Registered Nurse
- Winter Haven, FL
National Provider Identifier
1720455017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9355019
- Practice address
- 608 Lake Elizabeth Dr
Winter Haven, FL 33884-1434 - Phone
- (863) 206-2750
- NPI assigned
- Aug 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9355019 | FL | Primary |
Addresses
Primary practice location
608 Lake Elizabeth Dr
Winter Haven, FL 33884-1434
Mailing address
608 Lake Elizabeth Dr
Winter Haven, FL 33884-1434
Phone (863) 206-2750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163W00000X | Other | FL | 163W00000X |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9355019 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440115200000",
"number": "1720455017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 LAKE ELIZABETH DR",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338841434",
"telephone_number": "863-206-2750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 LAKE ELIZABETH DR",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338841434",
"telephone_number": "863-206-2750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASLEY",
"first_name": "KRISTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-21",
"last_updated": "2015-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9355019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "163W00000X",
"identifier": "163W00000X",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.