Provider Demographics
NPI:1184208035
Name:ALBURY, DESIREE JASMINE (RN)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:JASMINE
Last Name:ALBURY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:JASMINE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5005 64TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-9042
Mailing Address - Country:US
Mailing Address - Phone:561-379-0591
Mailing Address - Fax:
Practice Address - Street 1:30 HUNTER LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2499
Practice Address - Country:US
Practice Address - Phone:561-379-0591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9561343163W00000X
WARN60862782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse