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NPI 1780542498

NPI 1780542498 : KRISTINA LYNN RAY : KISSIMMEE, FL

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General NPI Number Information
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    NPI Number           |    1780542498
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTINA LYNN RAY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/12/2026
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    Last Update Date     |    01/12/2026
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Provider Practice Location Address
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    Address Line         |    4008 VIA TOLEDO CT 
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    City                 |    KISSIMMEE
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    State                |    FL
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    Zip                  |    34759-3924
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    Country              |    US
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    Telephone            |    513-403-3519
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4008 VIA TOLEDO CT 
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    City                 |    KISSIMMEE
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    State                |    FL
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    Zip                  |    34759-3924
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    Country              |    US
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    Telephone            |    513-403-3519
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    11044642
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    License Number State |    FL
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