Provider Demographics
NPI:1467950931
Name:ASBURY AND ASSOCIATES HEALTHCARE
Entity Type:Organization
Organization Name:ASBURY AND ASSOCIATES HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASBURY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:702-659-6138
Mailing Address - Street 1:4020 E RUSSELL RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3802
Mailing Address - Country:US
Mailing Address - Phone:702-659-6138
Mailing Address - Fax:702-381-5383
Practice Address - Street 1:4020 E RUSSELL RD BLDG 5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3802
Practice Address - Country:US
Practice Address - Phone:702-659-6138
Practice Address - Fax:702-381-5383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002538363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty