Provider Demographics
NPI:1982374674
Name:NASH, TESSICA FELICE
Entity Type:Individual
Prefix:
First Name:TESSICA
Middle Name:FELICE
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 1:1024 DOSSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-8562
Mailing Address - Country:US
Mailing Address - Phone:601-591-3043
Mailing Address - Fax:
Practice Address - Street 1:1024 DOSSVILLE RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-8562
Practice Address - Country:US
Practice Address - Phone:601-591-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver