Provider Demographics
NPI:1134630890
Name:NASH, MICHELLE KIRSTEN (MS, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:KIRSTEN
Last Name:NASH
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 TOR CT
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-3001
Mailing Address - Country:US
Mailing Address - Phone:413-997-5899
Mailing Address - Fax:413-997-5804
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-997-5899
Practice Address - Fax:413-997-5804
Is Sole Proprietor?:No
Enumeration Date:2017-10-20
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4401133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered