Provider Demographics
NPI:1881283257
Name:ASHLEY NICOLE JUSTE PLLC.
Entity type:Organization
Organization Name:ASHLEY NICOLE JUSTE PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:JUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:702-722-8984
Mailing Address - Street 1:7181 N HUALAPAI WAY # 130-200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1115
Mailing Address - Country:US
Mailing Address - Phone:702-751-4192
Mailing Address - Fax:866-656-3395
Practice Address - Street 1:9425 SAYAN CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-1665
Practice Address - Country:US
Practice Address - Phone:702-722-8984
Practice Address - Fax:866-656-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063959229Medicaid