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General NPI Number Information
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NPI Number | 1770699324
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Entity Type | Individual
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Provider Name | JANA KATHLEEN RAY BS,MPH,MPAS,DMSCPA-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | CAMP AS SALIYAH INTERNATIONAL SOS
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City | APO
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State | AE
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Zip | 00000
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Country | US
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Telephone | 850-322-6945
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 TAMPA ROAD PMB213
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City | PALM HARBOR
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State | FL
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Zip | 34683
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Country | US
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Telephone | 850-322-6945
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9102896
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA56715
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006718
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License Number State | GA
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