Provider Demographics
NPI:1346285475
Name:RAY, RITA M (CNM)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:PO BOX 1479
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31799-1479
Mailing Address - Country:US
Mailing Address - Phone:229-226-8800
Mailing Address - Fax:229-226-8232
Practice Address - Street 1:916 S BROAD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6113
Practice Address - Country:US
Practice Address - Phone:229-226-8800
Practice Address - Fax:229-226-8232
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN043729367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00302233FMedicaid
GA00302233DMedicaid
GA000302233GMedicaid