Provider Demographics
NPI:1235388703
Name:KAY, HEATHER J (CFNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:J
Last Name:KAY
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-1730
Mailing Address - Country:US
Mailing Address - Phone:304-273-1033
Mailing Address - Fax:304-273-1034
Practice Address - Street 1:512A CHURCH ST S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1616
Practice Address - Country:US
Practice Address - Phone:304-372-1033
Practice Address - Fax:304-373-0223
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV63927163WM0705X
WVAPRN63927NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV31-0942184OtherTAX ID
WV30-0404018OtherMSMC TAX ID