Provider Demographics
NPI:1154051407
Name:THOMAS-NASH, BETSY
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:THOMAS-NASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CECIL MALONE DR
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5124
Mailing Address - Country:US
Mailing Address - Phone:607-273-0466
Mailing Address - Fax:607-277-1494
Practice Address - Street 1:138 CECIL MALONE DR
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5124
Practice Address - Country:US
Practice Address - Phone:607-273-0466
Practice Address - Fax:607-277-1494
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY770334-01251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health