Provider Demographics
NPI:1750391397
Name:NASH, TAMMY LEE (PT)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LEE
Last Name:NASH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 NORTH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:NH
Mailing Address - Zip Code:03608
Mailing Address - Country:US
Mailing Address - Phone:603-499-3848
Mailing Address - Fax:
Practice Address - Street 1:3461 S COUNTY TRL STE 304
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1463
Practice Address - Country:US
Practice Address - Phone:401-398-7988
Practice Address - Fax:401-398-7990
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03785225100000X
NH1859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0069090OtherBLUE CROSS VERMONT
NH30009038Medicaid
NH0807633YONH02OtherANTHEM