Provider Demographics
NPI:1104042134
Name:KASH, MEREDITH ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANNE
Last Name:KASH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 VIRGINIA BEACH BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3114
Mailing Address - Country:US
Mailing Address - Phone:757-738-1300
Mailing Address - Fax:757-687-3202
Practice Address - Street 1:332 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1793
Practice Address - Country:US
Practice Address - Phone:757-473-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002036363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV5061A - C03895Medicare PIN