Healthcare Provider Details

I. General information

NPI: 1699204735
Provider Name (Legal Business Name): ANNA APPLEBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2017
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 VIA LEVANZO
HENDERSON NV
89011-3179
US

IV. Provider business mailing address

1032 SECLUDED ACRES CT
HENDERSON NV
89002-9225
US

V. Phone/Fax

Practice location:
  • Phone: 702-439-5625
  • Fax:
Mailing address:
  • Phone: 702-439-5625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberTAPRN701586
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberTAPRN701586
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: