Provider Demographics
NPI:1184434821
Name:NASH, JAMES MACK JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MACK
Last Name:NASH
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7565 E US HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-9120
Mailing Address - Country:US
Mailing Address - Phone:405-262-6555
Mailing Address - Fax:
Practice Address - Street 1:7565 E US HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-9120
Practice Address - Country:US
Practice Address - Phone:405-262-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach