Provider Demographics
NPI:1073219101
Name:RAY, KAREN YVETTE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:YVETTE
Last Name:RAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-1778
Mailing Address - Country:US
Mailing Address - Phone:404-977-0674
Mailing Address - Fax:
Practice Address - Street 1:260 SPRING RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-1778
Practice Address - Country:US
Practice Address - Phone:404-977-0674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle