black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

ASURION INSURANCE SERVICES INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN35488
Status:
First Licensure:
09/10/1992
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
140 11TH AVE N
NASHVILLE, TN 37203-6353
Mailing:
140 11TH AVE N
NASHVILLE, TN 37203-6353
Phone:
+1 (615) 837-3000
Fax:
+1 (816) 237-3535
Email:
agencylicensing@asurion.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 02/21/1996 04/01/2027
*** NOT ACTIVE *** 12/18/1995 02/20/1996
NON-RESIDENT PRODUCER AGENCY 09/10/1992 12/17/1995

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIANZ GLOBAL RISKS US INSURANCE COMPANY
12/13/2019 PCF780
HARTFORD ACCIDENT & INDEMNITY COMPANY
03/01/1996 PCF462 07/12/2007
HARTFORD CASUALTY INSURANCE COMPANY
03/01/1996 PCF967 07/12/2007
HARTFORD FIRE INSURANCE COMPANY
03/01/1996 PCF464 07/12/2007
HARTFORD INSURANCE COMPANY OF THE MIDWEST
03/01/1996 PCF1021 07/12/2007
HARTFORD UNDERWRITERS INSURANCE COMPANY
03/01/1996 PCF992 07/12/2007
LIBERTY INSURANCE UNDERWRITERS INC
08/05/2014 PCF175807
LIBERTY MUTUAL INSURANCE COMPANY
11/22/2005 PCF331
OLD REPUBLIC INSURANCE COMPANY
11/15/2007 PCF543 11/07/2019
PRAETORIAN INSURANCE COMPANY
03/31/2006 PCF68207 11/11/2008
PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD
03/11/2005 PCF47445 08/06/2008
TESLA INSURANCE COMPANY
07/05/2005 PCF50 03/08/2008
TWIN CITY FIRE INSURANCE COMPANY
03/01/1996 PCF963 07/12/2007

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
YADIRA ALVAREZ CARTER
10/18/2018 PRN317604
CRAIG NMN ANDERSON
12/18/2024 PRN423621
SHELLY LYNN AUSTIN
03/02/2012 PRN197773
DEREK KEITH BAILEY
10/05/2010 PRN181111
NICHOLAS BRADLEY BASQUILL-WHITE
12/28/2023 PRN468379
KATRINA BEDFORD
03/02/2012 PRN198956
TRENTON JOSEPH BLACK
04/13/2011 PRN188517
SHANNON LEE BRACKEN-BELLEW
05/24/2019 PRN279591
STEPHEN BRACY
12/18/2024 PRN245503
MORGAN BROCK
03/25/2024 PRN444754
JASON W. BRUCE
04/10/2025 PRN166054
JORDAN DENISE BULLARD
12/18/2024 PRN351885
TABATHA BURRELL
08/06/2019 PRN335220
BONNY DALIANA CAMACHO SIERRA
09/26/2023 PRN454591
ARIELLE CAMERON
07/14/2025 PRN518669
REGINA A. CAMPBELL
09/30/2025 PRN196942
MARIA CARABALLO
07/05/2017 PRN288987
JAMES CHAMBERLAIN
02/14/2019 PRN325251
JOY CHANCHAMPA
02/23/2010 PRN171070
TODD DONALD CHRETIEN
03/31/2009 PRN165030
WILLIAM EARL CLEVELAND
06/20/2017 PRN288317
KIMBERLY M. COMPTON
07/14/2025 PRN518360
JEFFREY CONNELL
01/23/2024 PRN337637
RICARDO RUBEN CORNEJO
07/14/2025 PRN346733
CLAUDIA LIZETH CORRAL VAZQUEZ
04/27/2018 PRN307193
CICELY C. COX
08/06/2021 PRN364514
CLINTON JAMES COX
08/06/2021 PRN386973
ANNE M. CRAIG
11/11/2019 PRN288320
VANESSIA CHERELLE MURPHY CREESE
04/10/2025 PRN418292
JASON CROCKER
01/31/2017 PRN281332
JOSEPH WILLIAM CROUCH
10/27/2025 PRN527436
MELISSA LYN CULPEPPER
12/13/2013 PRN225617
LATOYA D. DAVIS
08/06/2021 PRN367386
SARAH ELIZABETH DAY
08/06/2021 PRN353111
CARLOS BENJAMIN DEJESUS
02/17/2025 PRN412063
EDWARD FLOTILDE DELMUNDO
07/25/2017 PRN290212
DARIN DIAMOND
10/12/2011 PRN194901
SCOTT ROBERT DIEDERICH
07/11/2025 PRN519208
AMBER MARIE DIXON
03/13/2019 PRN185854
LAWRENCE HUTCHISON DOUGLAS
11/14/2018 PRN320888
RICHARD ELSNER
08/06/2021 PRN389184
ZACHARY L. ERVIN
06/08/2017 PRN287508
ALICIA ESPINOZA
05/13/2024 PRN483597
JOHN FALKUM
09/26/2023 PRN427174
MICHAEL J. FARIAS
07/10/2013 PRN217675
SHAYNE STEVEN FENIMORE
12/11/2019 PRN340564
JESSICA LYNN FORBES
05/19/2010 PRN176518
GEORGE PATRICK FORD
04/17/2020 PRN351110
MELISSA COLEEN FRIEND-MCCLURE
02/17/2025 PRN441255
EBONY SHARI GAINES
07/10/2015 PRN251863
ANTONIO SALVATORE GALLIZZI
10/18/2024 PRN498287
JOSHUA DAVID GAMINDE
08/06/2021 PRN384181
AURORA MARIA GARCIA
08/06/2021 PRN352069
LETICIA GAXIOLA
09/20/2018 PRN317315
DANA ANN GERMAIN
04/09/2024 PRN480973
STACEY GIBSON
02/17/2025 PRN412538
WILLIAM SCOTT GILBERT
08/29/2024 PRR364755
PATRICE ANTOINETTE GOOCH MCCLAIN
02/23/2010 PRN170748
JENNIFER A. GOYNE
04/04/2017 PRN166105
TRACY MICHELLE GRAVELY
08/11/2016 PRN261393
JERMAINE DERRELL GRAY
07/11/2025 PRN519235
TOSHA R. GREENWAY
05/23/2016 PRN265560
JUAN JOSE GUTIERREZ
06/18/2025 PRN196720
LACREACIA MICHELLE HALL
06/04/2014 PRN232950
JOSHUA WILLIAM HAMLIN
05/23/2012 PRN200029
BAYINNAH QUAHIRA HARDY
05/23/2024 PRN441124
JOHN W. HARMON
11/12/2024 PRN465745
IAN HARRIS
05/27/2024 PRN483700
LINDSAY D. HARRIS
06/08/2017 PRN287736
KATHY HINES
12/29/2011 PRN196952
TAMMY HOLLEY
04/11/2017 PRN284104
INGRID CAROLINA HUESCA
04/17/2020 PRN352008
JESSICA LYNN HUGHES
08/27/2025 PRN408668
MATTHEW DANIEL HUSKEY
12/11/2019 PRN337618
CASEY LEE HUTSELL
07/11/2017 PRN289498
ALFONSO JIMENEZ ZUNO
05/08/2017 PRN283672
LESLEY RENEE JOHNSON
06/13/2017 PRN144492
LORI LEE JOHNSON
01/15/2025 PRN445176
MARISA A. JOHNSON
09/26/2024 PRN492813
TANYA SUE JOYNER
08/18/2016 PRN271011
MONICA I. JUNGHANS
06/20/2018 PRN113768
JOHN JOSEPH KAZMIEROWICZ
12/01/2004 PRN108907
CAROL KEITH
06/20/2025 PRN516256
LINDSEY ALLYSON KELLER
11/13/2018 PRN320302
DONALD RAY KELLY
05/27/2024 PRN482769
DEBRA J. KERR
09/26/2011 PRN192963
JOHN CLAYBORNE KERSEY JR
07/15/2009 PRN167960
LEYANNE TRENEE KING
06/09/2015 PRN250189
VICTORIA LYNN KLEIN
10/18/2009 PRN171278
MUSULENG JUAH KLIMPACHER PADMORE
09/26/2024 PRN494842
PETER C. KOWALSKI
05/24/2019 PRN256501
CHARLES ALAN LAUE
03/21/2006 PRN70039
DANIEL WAYNE LEDFORD
02/14/2019 PRN324153
KIMBERLY DAWN LEONARD
08/04/2023 PRN117555
JONA ANN LEUCHTENBERG
01/31/2017 PRN281361
LEIGH ANN LIEN
02/03/2011 PRN185600
ANDREW RYAN LOGAN
06/07/2018 PRN310011
TIMOTHY MICHAEL LOONEY
08/06/2021 PRN355179
WENDY MELISSA LOWENTHAL
06/24/2016 PRN268444
ROSALYNN LY
08/06/2021 PRN385272
DEREK EUGENE LYONS
03/05/2015 PRN245881
EDITH MARIN
08/06/2019 PRN335055
ALFREDO MARTINEZ
08/04/2023 PRN408065
HENRY WOODROW MATHIS
12/11/2018 PRN322548
LISA M. MCCORMICK
12/28/2023 PRN252684
MARSHA KAYE MCFARLAND
09/30/2014 PRN238430
OTHO FREDERICK MEARS IV
01/02/2015 PRN214312
KARON K. MILLS HENDERSON
09/11/2024 PRN117509
CRYSTAL DAWN MITCHELL
11/11/2024 PRN500457
MAURNICE LASHEA MOORE
07/18/2017 PRN289943
RACHEL A. MYERS
07/07/2025 PRN519682
NICOLAS GAGE NEWBERRY
05/28/2024 PRN485021
ATOYIA SAMONE NORTON
01/31/2017 PRN136245
SHANTAL ALEXIS SOPHIA ORTEGA
03/27/2024 PRN407993
SETH PAI
12/28/2023 PRN462056
DANIELLE BETH PAQUEO
05/21/2024 PRN483703
BOBBIE PARADY
05/21/2024 PRN483701
LILLIAN PATRICK
01/24/2014 PRN226941
MARTIN PEREZ
03/24/2014 PRN230237
CURTIS PIERCE
07/10/2025 PRN520168
JUAN MIGUEL PISENO
08/08/2025 PRN337409
MICHELLE ALICIA PRATHER
02/12/2025 PRN428410
KHADIJAH RENEE PRICE
03/13/2024 PRN418322
DIANA QUINTANILLA
02/23/2010 PRN171085
JACOB R. RASDALL
11/05/2024 PRN499407
DEBORAH DENISE RAY WRIGHT
08/04/2023 PRN417857
ROBIN RAY
08/17/2012 PRN204901
SHEILA REDNOUR
10/22/2009 PRN171560
ALMA ROSA REYES
08/06/2021 PRN371624
ANGELICA REYES
09/27/2018 PRN316884
WILLIAM REYES
12/11/2019 PRN337450
ROBERT REYNOLDS
06/05/2024 PRN485285
QUINTESSA LASHAY ROBERTS
05/20/2024 PRN483702
ANN ROLLINSON
08/06/2021 PRN353939
PRECIOUS ALAI ROSS
09/24/2024 PRN417009
SHERRY EDITH ROSS
01/07/2004 PRN100753
LOUISE CHANTE RUTHERFORD PRAYLOR
05/20/2024 PRN484183
ALEJANDRINA CEPEDA SALINAS
02/20/2025 PRN444593
RORY BRENDAN SCANLAN
08/06/2021 PRN199034
RODNEY LEN SCHLOSSER
10/17/2006 PRN108903
BERNADETTE SCULLY
08/04/2023 PRN407243
ELVIS SHAW
08/16/2019 PRN334453
SARAH BETH SHEETS
08/04/2023 PRN407637
BRANDON SHERMAN
07/20/2011 PRN191167
JEFFREY J. SHORES
02/07/2011 PRN185597
SHERRY LOU SLONE
08/06/2021 PRN377454
CHAD THOMAS SMITH
08/05/2024 PRN489666
GREGORY LYNN SMITH
08/06/2021 PRN367908
PAUL BRYCEN SMITH
11/14/2018 PRN320952
TIMOTHY KARL STADTHAUS
01/16/2024 PRN166641
SCOTT STRAYER
01/02/2019 PRN322501
MANUEL A. SUPER
12/29/2011 PRN196585
ETHAN PATRICK SYLVESTER
10/15/2024 PRN428661
DAVID JAMSHID TAVAKOLI
11/27/2017 PRN298530
MICHAEL ANDREW TIMPONE
08/13/2018 PRN313761
SALVADOR ANGELO TODARO JR
06/08/2018 PRN308025
JASON A. TOMKINSON
03/19/2024 PRN478563
NOELLE EILEEN TRANSUE
12/29/2011 PRN196956
OZUMY TREVIZO
01/17/2012 PRN196691
LUCAS ANTHONY TROTTA
01/24/2025 PRN174137
AGBAI KALU UDE
05/24/2019 PRN211437
MATTHEW SHAWN ULLMAN
12/28/2023 PRN413685
ANNA LYDIA VALDEZ
01/31/2017 PRN274000
TAJHIA ANN VANDERKOOI
12/11/2019 PRN344505
ROXANA VASQUEZ
06/07/2018 PRN309837
JUDITH VELASQUEZ PORTILLO
08/08/2017 PRN291126
BLAKE VERBOOM
07/21/2025 PRN461794
JACOB D. VETTER
08/06/2021 PRN353269
JACOB WALCOTT
05/24/2019 PRN304514
MEREDITH RAE WALKER
12/11/2019 PRN340165
PATRICK DOUGLAS WAMHOFF
11/14/2018 PRN205728
AHMAD R. WATKINS
08/16/2019 PRN335279
CHEVETTE EVANDER WATKINS
05/23/2012 PRN199335
SHIRLEY JOSEPHINE WATSON
05/02/2019 PRN329717
NATHALIE ANNE WATTS
07/20/2010 PRN178761
FRANK PATTERSON WEBBER
09/05/2014 PRN237422
DUSTIN LEE WESTFAHL
08/06/2021 PRN352367
VICTORIA NICOLE WHITE
08/17/2012 PRN205658
ANDREW H. WILBURN
02/23/2010 PRN171109
JULIE M. WILLIAMS
10/12/2011 PRN194695
LACOSHA WILLIAMS
01/24/2025 PRN315282
LASHAUNA LYNN WILLIAMS
05/24/2019 PRN162036
TIMOTHY WILLIAMS
02/12/2024 PRN474073
TREVOR J. WILLIAMS
03/02/2012 PRN199181
ALICIA N. WILSON
01/31/2017 PRN274385
TEQUILLA LA TON WINROW
08/04/2023 PRN415459
MARC WISNER
12/28/2023 PRN462054
JOSHUA DANIEL WORTMAN
08/13/2024 PRN483836
MICHAEL WAYNE WRIGHT
12/16/2014 PRN118086
JAY PATRICK ZAZZARA
12/28/2023 PRN219980
STEPHEN LEE ZEIBER
04/21/2025 PRN203597

Branch Office

Name Issue Date License Number Expiration Date Cancel Date
ASURION INSURANCE SERVICES INC (BRIDGEWATER, NJ)
06/15/2020 BRN355141
ASURION INSURANCE SERVICES INC (HOUSTON TX)
10/14/2009 BRN171195
ASURION INSURANCE SERVICES INC (HOUSTON TX)
02/15/2019 BRN326585
ASURION INSURANCE SERVICES INC (LAS VEGAS NV)
04/11/2017 BRN285378
ASURION INSURANCE SERVICES INC (LEAWOOD KS)
12/01/2016 BRN279398
ASURION INSURANCE SERVICES INC (MIRAMAR FL)
10/14/2009 BRN171196
ASURION INSURANCE SERVICES INC (PHOENIX AZ)
04/11/2017 BRN285379
ASURION INSURANCE SERVICES INC (RUSSELLVILLE AR)
04/07/2017 BRN285248
ASURION INSURANCE SERVICES INC (STERLING VA)
04/11/2017 BRN285377

Supervised Entity

Name Issue Date License Number Expiration Date Cancel Date
BANGOR CELLULAR TELEPHONE LIMITED PARTNERSHIP
12/24/2019 EDR211712
COX WIRELESS, LLC
09/29/2021 EDN397893
MAINE RSA #1 INC
12/24/2019 EDR211711
MAINE RSA #4 INC
12/24/2019 EDR211715
VERIZON WIRELESS SERVICES LLC
12/27/2011 EDN198512

Responsible Individual

Name License Number
JEFFREY CONNELL PRN337637

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
1992443

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 11/19/2025 01:53:25 AM