Provider Demographics
NPI:1215294764
Name:THRASH, KAY SHAW (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:SHAW
Last Name:THRASH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:KAY
Other - Last Name:SHAW THRASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:420 LOWELL DR SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3754
Mailing Address - Country:US
Mailing Address - Phone:256-535-5944
Mailing Address - Fax:256-535-5959
Practice Address - Street 1:420 LOWELL DR SE
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3754
Practice Address - Country:US
Practice Address - Phone:256-535-5944
Practice Address - Fax:256-535-5959
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-025143363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology