Provider Demographics
NPI:1043996531
Name:MAYES, KRISTA L (RN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:MAYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1316 SOMERVILLE RD SE STE 1
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4309
Mailing Address - Country:US
Mailing Address - Phone:256-260-7361
Mailing Address - Fax:256-355-6092
Practice Address - Street 1:295 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1210
Practice Address - Country:US
Practice Address - Phone:256-260-7361
Practice Address - Fax:256-355-6092
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-150721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse