Healthcare Provider Details

I. General information

NPI: 1932607264
Provider Name (Legal Business Name): OTHESHA MARIE NASH APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 SKYLAND DR
MACEDONIA OH
44056-1045
US

IV. Provider business mailing address

720 SKYLAND DR
MACEDONIA OH
44056-1045
US

V. Phone/Fax

Practice location:
  • Phone: 216-710-5247
  • Fax: 216-710-5245
Mailing address:
  • Phone: 216-710-5247
  • Fax: 216-710-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2021001135
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022231
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: