Healthcare Provider Details

I. General information

NPI: 1083288666
Provider Name (Legal Business Name): KASEY GRAHAM MAYS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 KENT RD STE 1
TIFTON GA
31794-1697
US

IV. Provider business mailing address

39 KENT RD STE 1
TIFTON GA
31794-1697
US

V. Phone/Fax

Practice location:
  • Phone: 229-391-4310
  • Fax: 229-391-4243
Mailing address:
  • Phone: 229-391-4310
  • Fax: 229-391-4243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP176481
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: