Basic Information
| Provider Information | |||||||||
| NPI: | 1285120477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASH | ||||||||
| FirstName: | NICOLE | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, APRN, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2654 EITEL RD | ||||||||
| Address2: | |||||||||
| City: | CHASKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553181504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6127022403 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1805 HENNEPIN AVE N | ||||||||
| Address2: | |||||||||
| City: | GLENCOE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3208643121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 09/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 1905175 | MN | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 367500000X | 2235 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.