Provider Demographics
NPI:1073794285
Name:RAY, KATE JENNINGS (PMH-NP)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:JENNINGS
Last Name:RAY
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 24TH ST
Mailing Address - Street 2:ATTN: MCXO-BHS
Mailing Address - City:FORT LEE
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1716
Mailing Address - Country:US
Mailing Address - Phone:804-734-9143
Mailing Address - Fax:804-734-9188
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:ATTN: MCXO-BHS
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9143
Practice Address - Fax:804-734-9188
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167551163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health