Provider Demographics
NPI:1093387821
Name:NASH, SHANNON (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:NASH
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4042
Mailing Address - Country:US
Mailing Address - Phone:941-365-3913
Mailing Address - Fax:941-296-7806
Practice Address - Street 1:736 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4042
Practice Address - Country:US
Practice Address - Phone:941-365-3913
Practice Address - Fax:941-296-7806
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011968363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner