Basic Information
| Provider Information | |||||||||
| NPI: | 1033357439 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EASTON | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | LARAE | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | GORDON | ||||||||
| State: | NE | ||||||||
| PostalCode: | 693431402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3082821475 | ||||||||
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| Practice Location | |||||||||
| Address1: | EAST HIGHWAY 18 | ||||||||
| Address2: | PINE RIDGE IHS | ||||||||
| City: | PINE RIDGE | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6058673068 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2009 | ||||||||
| LastUpdateDate: | 01/23/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 59899 | NE | Y | Nursing Service Providers | Registered Nurse |
No ID Information.