Provider Demographics
NPI:1417531930
Name:VERSLUYS, ASHLEY D (AGNP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:D
Last Name:VERSLUYS
Suffix:
Gender:F
Credentials:AGNP
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:MSC 8234-05-02
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7260
Mailing Address - Fax:314-362-6288
Practice Address - Street 1:4600 MEMORIAL DR
Practice Address - Street 2:DIV SURG CT ADULT CARDIO, STE 100
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5368
Practice Address - Country:US
Practice Address - Phone:314-362-7260
Practice Address - Fax:314-747-4216
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209023360363LG0600X
IL041353152163WC0200X
IL209.023360363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420118894Medicaid