Provider Demographics
NPI:1417507724
Name:EAST, KAY G
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:G
Last Name:EAST
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 1:10600 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:DISPUTANTA
Mailing Address - State:VA
Mailing Address - Zip Code:23842-6607
Mailing Address - Country:US
Mailing Address - Phone:804-586-6000
Mailing Address - Fax:
Practice Address - Street 1:10600 CENTENNIAL RD
Practice Address - Street 2:
Practice Address - City:DISPUTANTA
Practice Address - State:VA
Practice Address - Zip Code:23842-6607
Practice Address - Country:US
Practice Address - Phone:804-586-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider