Provider Demographics
NPI:1326160516
Name:GASH, BRIAN (RNFA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GASH
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3961 FLOYD RD
Mailing Address - Street 2:SUITE 300-350
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-8535
Mailing Address - Country:US
Mailing Address - Phone:404-226-7769
Mailing Address - Fax:770-739-0848
Practice Address - Street 1:3961 FLOYD RD
Practice Address - Street 2:SUITE 300-350
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8535
Practice Address - Country:US
Practice Address - Phone:404-226-7769
Practice Address - Fax:770-739-0848
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN086682163WR0006X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant