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NPI Code Detail

MEDICARE: MARY ANGELA RAYHILL APRN

MEDICARE:   MARY ANGELA RAYHILL  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner3003757KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000052154HOTHERKYHUMANA - NMA
250003388OTHERKYPASSPORT & PASSPORT ADVANTAGE - NMA
3000000350669OTHERKYANTHEM - NMA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5035357OTHERKYSIHO - NMA

General Provider Information

NPI Number : 1780649749
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANGELA RAYHILL APRN
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5116
Provider Business Practice Location Address
First Line : 300 HIGH POINT CT
Second Line :
City : MT WASHINGTON
State : KY
Zip : 40047-6560
Country : US
Telephone Number : 502-955-6129
Fax Number : 502-955-8164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 05/25/2022

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Directions to “ MARY ANGELA RAYHILL APRN” Practice Location

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