Healthcare Provider Details
I. General information
NPI: 1689634735
Provider Name (Legal Business Name): MICHELLE MARION NASH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/24/2006
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2665 STATE ROAD 580
CLEARWATER FL
33761-3166
US
IV. Provider business mailing address
PO BOX 278
ODESSA FL
33556-0278
US
V. Phone/Fax
- Phone: 727-725-5121
- Fax: 727-725-5417
- Phone: 813-766-3925
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | APRN2554102 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | APRN2554102 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: