Healthcare Provider Details

I. General information

NPI: 1235388703
Provider Name (Legal Business Name): HEATHER J KAY CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512A CHURCH ST S
RIPLEY WV
25271-1616
US

IV. Provider business mailing address

606 WASHINGTON ST
RAVENSWOOD WV
26164-1730
US

V. Phone/Fax

Practice location:
  • Phone: 304-372-1033
  • Fax: 304-373-0223
Mailing address:
  • Phone: 304-273-1033
  • Fax: 304-273-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number63927
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN63927NP
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: