Provider Demographics
NPI:1013148311
Name:NASH, MISTI T (PT, CWS, FACCWS)
Entity type:Individual
Prefix:MRS
First Name:MISTI
Middle Name:T
Last Name:NASH
Suffix:
Gender:F
Credentials:PT, CWS, FACCWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 STONEHAVEN CV
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2036
Mailing Address - Country:US
Mailing Address - Phone:731-313-1833
Mailing Address - Fax:
Practice Address - Street 1:118 DEVONSHIRE SQ
Practice Address - Street 2:SUITE 7
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2255
Practice Address - Country:US
Practice Address - Phone:731-660-5902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist