Provider Demographics
NPI:1285112615
Name:PASCUA, KIMBRELLE ANNE (APRN)
Entity type:Individual
Prefix:
First Name:KIMBRELLE
Middle Name:ANNE
Last Name:PASCUA
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4643
Mailing Address - Country:US
Mailing Address - Phone:775-884-4567
Mailing Address - Fax:775-884-4569
Practice Address - Street 1:1385 VISTA LN
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4643
Practice Address - Country:US
Practice Address - Phone:775-884-4567
Practice Address - Fax:775-884-4569
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811217363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner