Provider Demographics
NPI:1710643903
Name:NASH, ANGELA MARIE (MSNFM)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:NASH
Suffix:
Gender:F
Credentials:MSNFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26631
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0631
Mailing Address - Country:US
Mailing Address - Phone:512-228-4080
Mailing Address - Fax:
Practice Address - Street 1:3906 PETES PATH
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6121
Practice Address - Country:US
Practice Address - Phone:512-228-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty