Basic Information
Provider Information
NPI: 1235717216
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NASH
FirstName: BECKY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BSN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SLADE
OtherFirstName: BECKY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 8001 S US HIGHWAY 75
Address2:  
City: SHERMAN
State: TX
PostalCode: 750905707
CountryCode: US
TelephoneNumber: 9035321400
FaxNumber:  
Practice Location
Address1: 8001 S US HIGHWAY 75
Address2:  
City: SHERMAN
State: TX
PostalCode: 750905707
CountryCode: US
TelephoneNumber: 9035321400
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/31/2021
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X980286TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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