Provider Demographics
NPI:1124313390
Name:BEARD, ASHLEY NICOLLE (BA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLLE
Last Name:BEARD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLLE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:895 ROBERTA LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-6810
Mailing Address - Country:US
Mailing Address - Phone:775-331-6252
Mailing Address - Fax:775-331-6250
Practice Address - Street 1:895 ROBERTA LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-6810
Practice Address - Country:US
Practice Address - Phone:775-331-6252
Practice Address - Fax:775-331-6250
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner