Individual
MARY W NASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900
Mailing address
880 RICHLAND EAST DR, RICHLAND, MS 39218-9532
(662) 402-9443
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R874735
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07609817
—
MS
Enumeration date
01/21/2015
Last updated
02/07/2019
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