Provider Demographics
NPI:1588922058
Name:NASH-FAIRFAX, ERIN ELIZABETH (EMT-P, RN, PA-C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:NASH-FAIRFAX
Suffix:
Gender:F
Credentials:EMT-P, RN, PA-C
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:NASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMT-P, RN
Mailing Address - Street 1:29798 HAUN RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-6541
Mailing Address - Country:US
Mailing Address - Phone:951-679-9700
Mailing Address - Fax:951-672-0835
Practice Address - Street 1:29798 HAUN RD
Practice Address - Street 2:SUITE 207
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-6541
Practice Address - Country:US
Practice Address - Phone:951-679-9700
Practice Address - Fax:951-672-0835
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22180363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant