Provider Demographics
NPI:1427831098
Name:NASHWELL, LLC
Entity type:Organization
Organization Name:NASHWELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-861-9466
Mailing Address - Street 1:PO BOX 34428
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0622
Mailing Address - Country:US
Mailing Address - Phone:615-861-9466
Mailing Address - Fax:615-309-0756
Practice Address - Street 1:1416 WILLOWBROOKE CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7199
Practice Address - Country:US
Practice Address - Phone:615-861-9466
Practice Address - Fax:615-309-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty