Provider Demographics
NPI:1619336054
Name:NASSER, KAILA
Entity Type:Individual
Prefix:MS
First Name:KAILA
Middle Name:
Last Name:NASSER
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 1:202 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8683
Mailing Address - Country:US
Mailing Address - Phone:919-584-0050
Mailing Address - Fax:
Practice Address - Street 1:202 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-8683
Practice Address - Country:US
Practice Address - Phone:919-584-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program