Provider Demographics
NPI:1215001920
Name:NASH, JUDITH MARY (RN FNP)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MARY
Last Name:NASH
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:PETROLIA
Mailing Address - State:CA
Mailing Address - Zip Code:95558
Mailing Address - Country:US
Mailing Address - Phone:707-629-3318
Mailing Address - Fax:
Practice Address - Street 1:733 CEDAR ST
Practice Address - Street 2:
Practice Address - City:GARBERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95542-3201
Practice Address - Country:US
Practice Address - Phone:707-923-3921
Practice Address - Fax:707-923-3902
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9649363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner