Healthcare Provider Details

I. General information

NPI: 1982424644
Provider Name (Legal Business Name): MRS. NELL A MAYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 VICAR PL
DANVILLE VA
24540-1241
US

IV. Provider business mailing address

96 HOLBROOK LN
RAPHINE VA
24472-2320
US

V. Phone/Fax

Practice location:
  • Phone: 434-272-8372
  • Fax:
Mailing address:
  • Phone: 540-817-5104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0704017386
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: