Provider Demographics
NPI:1033502588
Name:MAAS, KAYLEIGH REBECCA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAYLEIGH
Middle Name:REBECCA
Last Name:MAAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLEIGH
Other - Middle Name:REBECCA
Other - Last Name:BOOTHBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-4068
Mailing Address - Country:US
Mailing Address - Phone:603-577-2273
Mailing Address - Fax:603-577-5191
Practice Address - Street 1:29 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-4068
Practice Address - Country:US
Practice Address - Phone:603-577-2273
Practice Address - Fax:603-577-5191
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1074363A00000X
MAPA5261363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant