Provider Demographics
NPI:1942992037
Name:NASH, SANDRA YVONNE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:YVONNE
Last Name:NASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15802 HALLIDAY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3245
Mailing Address - Country:US
Mailing Address - Phone:216-534-2453
Mailing Address - Fax:
Practice Address - Street 1:15802 HALLIDAY AVE APT 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3245
Practice Address - Country:US
Practice Address - Phone:216-534-2453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide