MEDICARE: MR. CHRISTOPHER MICHAEL RAY

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	163W00000X	Registered Nurse	RN.1622973	CO

General Provider Information

NPI Number	:	1972195758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER MICHAEL RAY

Provider Business Mailing Address
First Line	:	3524 AIRFIELD RD RM 103
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4701
Country	:	US
Telephone Number	:	719-524-6625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3524 AIRFIELD RD RM 103
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4701
Country	:	US
Telephone Number	:	719-524-6625
Fax Number	:

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/03/2021

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