Provider Demographics
NPI:1922329291
Name:NASH, KAYON NICOLA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:KAYON
Middle Name:NICOLA
Last Name:NASH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 E 91ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4906
Mailing Address - Country:US
Mailing Address - Phone:646-912-1858
Mailing Address - Fax:
Practice Address - Street 1:1482 E 91ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4906
Practice Address - Country:US
Practice Address - Phone:646-912-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY611141163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice