Provider Demographics
NPI:1578853412
Name:ASBURY, DORIS ANN (NURSE)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:ANN
Last Name:ASBURY
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18351
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32417-8351
Mailing Address - Country:US
Mailing Address - Phone:850-348-0445
Mailing Address - Fax:850-249-2663
Practice Address - Street 1:115 W LESLIE LN
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-3951
Practice Address - Country:US
Practice Address - Phone:850-348-0445
Practice Address - Fax:850-249-2663
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN 5197693164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse