Provider Demographics
NPI:1174084271
Name:JANET NASH
Entity type:Organization
Organization Name:JANET NASH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JA'NET
Authorized Official - Middle Name:ALLYN
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:469-222-8338
Mailing Address - Street 1:2923 LA RODA
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6502
Mailing Address - Country:US
Mailing Address - Phone:469-222-8338
Mailing Address - Fax:
Practice Address - Street 1:2923 LA RODA
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-6502
Practice Address - Country:US
Practice Address - Phone:469-222-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty