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Individual

MRS. NICOLE MARIE NASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.ED.

Contact information

Practice address
1300 E WATSON DR, TEMPE, AZ 85283-3143
(480) 897-7122
(480) 820-8503
Mailing address
5343 W. FREMONT RD., LAVEEN, AZ 85339
(602) 237-2673

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3658163
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
955891
AHCCCS
AZ
Enumeration date
12/11/2006
Last updated
02/08/2011
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