Provider Demographics
NPI:1164202115
Name:O'MAY, KRISTEN JEAN (RN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JEAN
Last Name:O'MAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:JEAN
Other - Last Name:DEVOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 E PACES FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2233
Mailing Address - Country:US
Mailing Address - Phone:443-506-9018
Mailing Address - Fax:
Practice Address - Street 1:255 E PACES FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2233
Practice Address - Country:US
Practice Address - Phone:443-506-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166123163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse