Healthcare Provider Details

I. General information

NPI: 1760564025
Provider Name (Legal Business Name): CLARICE ALDINE NASH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLARICE ALDINE ROGERS RN

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12215 RIDGEPOINT CIR NW
SILVERDALE WA
98383-9493
US

IV. Provider business mailing address

12215 RIDGEPOINT CIR NW
SILVERDALE WA
98383-9493
US

V. Phone/Fax

Practice location:
  • Phone: 360-990-3648
  • Fax: 360-698-2869
Mailing address:
  • Phone: 360-990-3648
  • Fax: 360-698-2869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30002461
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: