Provider Demographics
NPI:1164014247
Name:CASH, KELLY LYNNE (FNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LYNNE
Last Name:CASH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:LYNNE
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9300 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5024
Mailing Address - Country:US
Mailing Address - Phone:805-212-6776
Mailing Address - Fax:
Practice Address - Street 1:8280 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3954
Practice Address - Country:US
Practice Address - Phone:805-464-2991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016630363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner