Provider Demographics
NPI:1841283959
Name:NASH, KAY M (PA-C)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:M
Last Name:NASH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:M
Other - Last Name:CENTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:242 BRUNSWICK ST
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1613
Mailing Address - Country:US
Mailing Address - Phone:207-827-6128
Mailing Address - Fax:207-907-7079
Practice Address - Street 1:242 BRUNSWICK ST
Practice Address - Street 2:
Practice Address - City:OLD TOWN
Practice Address - State:ME
Practice Address - Zip Code:04468-1613
Practice Address - Country:US
Practice Address - Phone:207-827-6128
Practice Address - Fax:207-907-7079
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1339363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8401010Medicaid
WA8805129Medicare ID - Type Unspecified
WA8401010Medicaid