Provider Demographics
NPI:1730548868
Name:ACLIS, NASHORIA K (CRNA)
Entity type:Individual
Prefix:MRS
First Name:NASHORIA
Middle Name:K
Last Name:ACLIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NASHORIA
Other - Middle Name:K
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1284
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37011-1284
Mailing Address - Country:US
Mailing Address - Phone:615-473-3993
Mailing Address - Fax:
Practice Address - Street 1:270 TAMPA DR APT D12
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3970
Practice Address - Country:US
Practice Address - Phone:615-473-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010936367500000X
TN176551390200000X
OH421491390200000X
OHARNP.CRNA.019303367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program