Healthcare Provider Details

I. General information

NPI: 1205562774
Provider Name (Legal Business Name): KATHY ELAINE HAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 N 4TH ST
OAKLAND MD
21550-1375
US

IV. Provider business mailing address

251 N 4TH ST
OAKLAND MD
21550-1375
US

V. Phone/Fax

Practice location:
  • Phone: 301-533-4271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR242235
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: