Provider Demographics
NPI:1346291432
Name:NASH, DANA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANN
Last Name:NASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6263 POPLAR AVE
Mailing Address - Street 2:SUITE 1052
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4701
Mailing Address - Country:US
Mailing Address - Phone:901-761-6157
Mailing Address - Fax:901-761-4145
Practice Address - Street 1:6263 POPLAR AVE
Practice Address - Street 2:SUITE 1052
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-761-6157
Practice Address - Fax:901-761-4145
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17777207Q00000X
TN36911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI23467Medicare UPIN
MS080004031Medicare PIN
TN3827532Medicare PIN
TN103I089839Medicare PIN
MS476929Medicare PIN
MS080004251Medicare PIN