Provider Demographics
NPI:1780895672
Name:NASH, ADRIENNE L (APRN)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:L
Last Name:NASH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3210
Mailing Address - Country:US
Mailing Address - Phone:203-454-2428
Mailing Address - Fax:203-454-2447
Practice Address - Street 1:215 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3210
Practice Address - Country:US
Practice Address - Phone:203-454-2428
Practice Address - Fax:203-454-2447
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003011363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health