Individual
JERRY LOUIS NASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
1205 SECOND ST, PELAHATCHIE, MS 39145-3050
(601) 825-7280
(601) 825-8130
Mailing address
PO BOX 24116, JACKSON, MS 39225-4116
(601) 825-7280
(601) 825-8130
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R861839
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04274568
—
MS
Enumeration date
08/06/2008
Last updated
10/14/2016
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