Provider Demographics
NPI:1396413357
Name:BORRADAILE, ASHER ANNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHER
Middle Name:ANNE
Last Name:BORRADAILE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHER
Other - Middle Name:ANNE
Other - Last Name:BENEZRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 VENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6515
Mailing Address - Country:US
Mailing Address - Phone:301-728-2783
Mailing Address - Fax:
Practice Address - Street 1:2001 N FLAGLER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6109
Practice Address - Country:US
Practice Address - Phone:561-659-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015216363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health