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General NPI Number Information
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NPI Number | 1417531930
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Entity Type | Individual
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Provider Name | ASHLEY D VERSLUYS AGNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 4500 MEMORIAL DR
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City | BELLEVILLE
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State | IL
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Zip | 62226-5360
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Country | US
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Telephone | 618-257-6220
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Fax | 618-257-6679
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-0001
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Country | US
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Telephone | 618-257-6220
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Fax | 618-257-6679
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209023360
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209023360
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License Number State | IL
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