Provider Demographics
NPI:1174833917
Name:AGEE, AUNBERRE M
Entity Type:Individual
Prefix:MRS
First Name:AUNBERRE
Middle Name:M
Last Name:AGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5046
Mailing Address - Country:US
Mailing Address - Phone:702-487-3349
Mailing Address - Fax:702-487-3349
Practice Address - Street 1:3000 CARROLL ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5046
Practice Address - Country:US
Practice Address - Phone:702-487-3349
Practice Address - Fax:702-487-3349
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner