Provider Demographics
NPI:1417435595
Name:NASH, REBEKAH GEETA MARIE (MA)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:GEETA MARIE
Last Name:NASH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 E 470 RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3737
Mailing Address - Country:US
Mailing Address - Phone:918-342-0770
Mailing Address - Fax:
Practice Address - Street 1:418 WYANDOTTE ST
Practice Address - Street 2:
Practice Address - City:SOUTH COFFEYVILLE
Practice Address - State:OK
Practice Address - Zip Code:74072
Practice Address - Country:US
Practice Address - Phone:620-515-4843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator