Provider Demographics
NPI:1871980763
Name:ANSLEY, BERTHA (RN)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:
Last Name:ANSLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 4TH ST SW
Mailing Address - Street 2:W600
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2320
Mailing Address - Country:US
Mailing Address - Phone:202-554-0365
Mailing Address - Fax:
Practice Address - Street 1:10775 BRIDLEREIN TER
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3650
Practice Address - Country:US
Practice Address - Phone:410-500-2357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-19
Last Update Date:2015-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1022583163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health