Provider Demographics
NPI:1184197519
Name:NASH, KARA ELIZABETH
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:ELIZABETH
Last Name: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 1:3411 E RHETT BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8522
Mailing Address - Country:US
Mailing Address - Phone:860-573-5918
Mailing Address - Fax:
Practice Address - Street 1:139 E OLD TRENTON RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5845
Practice Address - Country:US
Practice Address - Phone:800-991-6070
Practice Address - Fax:800-991-6071
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician