Provider Demographics
NPI:1487604583
Name:NASH, NORA J
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:J
Last Name:NASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 N 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-4852
Mailing Address - Country:US
Mailing Address - Phone:414-466-9161
Mailing Address - Fax:
Practice Address - Street 1:4657 N 71ST ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4852
Practice Address - Country:US
Practice Address - Phone:414-466-9161
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3882564950Medicaid
WI3289639100Medicaid
WI39959000OtherPROVIDER NUMBER