Provider Demographics
NPI:1851531305
Name:VANLEUVEN, ANASTASIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:VANLEUVEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3157 N RAINBOW BLVD
Mailing Address - Street 2:#518
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4578
Mailing Address - Country:US
Mailing Address - Phone:702-386-4700
Mailing Address - Fax:702-386-4701
Practice Address - Street 1:7220 S CIMARRON RD
Practice Address - Street 2:#270
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-386-4700
Practice Address - Fax:702-386-4701
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1145363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV115285OtherMEDICARE PTAN
NVPA1145OtherNEVADA STATE BOARD
NVPA1145OtherNEVADA STATE BOARD