1336194554 NPI number — MRS. TONYA HAYES NASH MSPAS, PA

Table of content: MRS. TONYA HAYES NASH MSPAS, PA (NPI 1336194554)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336194554 NPI number — MRS. TONYA HAYES NASH MSPAS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NASH
Provider First Name:
TONYA
Provider Middle Name:
HAYES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSPAS, PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336194554
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3493 VETERANS DR N
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
HUNTINGDON
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38344-6227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-986-2933
Provider Business Mailing Address Fax Number:
731-986-2938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14201 HIGHWAY 79 N
Provider Second Line Business Practice Location Address:
UNIT 4
Provider Business Practice Location Address City Name:
BUCHANAN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38222-4183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-986-2933
Provider Business Practice Location Address Fax Number:
731-986-2938
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  PA0000001388 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3665170 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com