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NPI Code Detail

MEDICARE: MS. ROXANNE NASH LCSW

MEDICARE: MS. ROXANNE NASH LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2IL0178OTHERILJOHN DEERE PROVIDER NUMBE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
499016OTHERILBLUE CROSS IOWA NUMBER

General Provider Information

NPI Number : 1235122060
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROXANNE NASH LCSW
Provider Business Mailing Address
First Line : 4602 3RD ST
Second Line :
City : MOLINE
State : IL
Zip : 61265-6106
Country : US
Telephone Number : 309-779-2031
Fax Number :
Provider Business Practice Location Address
First Line : 4600 3RD ST
Second Line :
City : MOLINE
State : IL
Zip : 61265-6106
Country : US
Telephone Number : 309-779-2031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 07/09/2007

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Directions to “ MS. ROXANNE NASH LCSW” Practice Location

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