MEDICARE: MRS. CHRISTY JOY RAY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4028464	KY

General Provider Information

NPI Number	:	1376368621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTY JOY RAY APRN

Provider Business Mailing Address
First Line	:	415 CHRISMAN OAKS TRL
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-7016
Country	:	US
Telephone Number	:	859-699-3865
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 CENTRE PKWY STE 101
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-3267
Country	:	US
Telephone Number	:	859-303-4657
Fax Number	:	859-938-5022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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