Provider Demographics
NPI:1952431116
Name:NASH, JESSICA LAUREN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LAUREN
Last Name:NASH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9662 CANTERBURY RIDING
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1401
Mailing Address - Country:US
Mailing Address - Phone:703-655-2403
Mailing Address - Fax:
Practice Address - Street 1:6800 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-3238
Practice Address - Country:US
Practice Address - Phone:301-735-8401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer