Provider Demographics
NPI:1508441064
Name:NASH, HOLLI (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:
Last Name:NASH
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 FAIRFAX LN
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6937
Mailing Address - Country:US
Mailing Address - Phone:469-865-6829
Mailing Address - Fax:
Practice Address - Street 1:13737 NOEL RD STE 1600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-1374
Practice Address - Country:US
Practice Address - Phone:888-513-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031694363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care