| Avery Nash, NP | |
|
101 Lexington Dr Ste A, Gluckstadt, MS 39110-6986 | |
| (601) 707-3771 | |
| (601) 707-3751 |
| Full Name | Avery Nash |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 101 Lexington Dr Ste A, Gluckstadt, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588481733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 906808 (Mississippi) | Primary |
| Entity Name | Gluckstadt Tc Kids, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255947297 PECOS PAC ID: 5496160210 Enrollment ID: O20210209000428 |
| Mailing Address | Practice Location Address |
|---|---|
| Avery Nash, NP 119 Greens View Dr, Madison, MS 39110-8050 Ph: (601) 421-1075 | Avery Nash, NP 101 Lexington Dr Ste A, Gluckstadt, MS 39110-6986 Ph: (601) 707-3771 |
Laura K Tanksley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1040 Gluckstadt Rd Ste B, Gluckstadt, MS 39110 Phone: 601-605-0452 | |
Clarence D Hayes, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 113 First Colony Blvd, Gluckstadt, MS 39110 Phone: 601-807-1624 | |
Bryce Hughes, PNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 101 Lexington Dr, Gluckstadt, MS 39110 Phone: 601-707-3771 |