Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 625887 | TX |
NPI | 1063443521 |
---|---|
Provider Name | Janet A Nash |
First Address | Grand Prairie, TX 75054-6502 |
Second Address | Grand Prairie, TX 75054-6502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 25/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S51550 | (02) |