Basic Information
| Provider Information | |||||||||
| NPI: | 1679573463 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASH | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ALBERT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6407 OLD COSTA LN | ||||||||
| Address2: | |||||||||
| City: | SCHOFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544764357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152419209 | ||||||||
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| Practice Location | |||||||||
| Address1: | 425 PINE RIDGE BLVD | ||||||||
| Address2: | STE 209 | ||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544014123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158470400 | ||||||||
| FaxNumber: | 7158470401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2005 | ||||||||
| LastUpdateDate: | 12/07/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1183 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.