Provider Demographics
NPI:1609308618
Name:NASH, KRISTEN MARIE (DO, MPH)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:NASH
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:EVARTS
Mailing Address - State:KY
Mailing Address - Zip Code:40828-0039
Mailing Address - Country:US
Mailing Address - Phone:603-359-4487
Mailing Address - Fax:
Practice Address - Street 1:209 E MOUND ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831-2321
Practice Address - Country:US
Practice Address - Phone:606-573-1975
Practice Address - Fax:606-837-2111
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine