Provider Demographics
NPI:1578178885
Name:ASBERRY, MELBA
Entity Type:Individual
Prefix:
First Name:MELBA
Middle Name:
Last Name:ASBERRY
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 1:41402 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1259
Mailing Address - Country:US
Mailing Address - Phone:440-213-5782
Mailing Address - Fax:
Practice Address - Street 1:331 BRITTANY LN
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-4170
Practice Address - Country:US
Practice Address - Phone:440-231-5782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide