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General NPI Number Information
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NPI Number | 1720873979
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Entity Type | Individual
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Provider Name | JAHANNA RAY NP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 2300 MANCHESTER EXPY STE 2001
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City | COLUMBUS
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State | GA
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Zip | 31904-6877
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Country | US
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Telephone | 706-323-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 121 LEE ROAD 2148
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City | SMITHS STATION
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State | AL
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Zip | 36877-2122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 168971
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License Number State | GA
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