Provider Demographics
NPI:1073013033
Name:NASH, DEVON I
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:NASH
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28000 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2271
Mailing Address - Country:US
Mailing Address - Phone:586-610-8734
Mailing Address - Fax:
Practice Address - Street 1:700 WEEB EWBANK WAY
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-3518
Practice Address - Country:US
Practice Address - Phone:586-610-8734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer