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General NPI Number Information
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NPI Number | 1710496187
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Entity Type | Individual
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Provider Name | STEPHEN NASH FNP
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Gender | Male
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6227 FRANKFORT HWY
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City | BENZONIA
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State | MI
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Zip | 49616-8632
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Country | US
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Telephone | 231-882-9661
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Fax | 231-882-1049
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Provider Business Mailing Address
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Address Line | 6227 FRANKFORT HWY
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City | BENZONIA
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State | MI
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Zip | 49616-8632
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Country | US
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Telephone | 231-882-9661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704282514
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License Number State | MI
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