Provider Demographics
NPI:1598375784
Name:MAY, ABBY NICHOLE
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:NICHOLE
Last Name:MAY
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 1:1447 BALDWIN CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-8268
Mailing Address - Country:US
Mailing Address - Phone:850-766-6563
Mailing Address - Fax:
Practice Address - Street 1:1021 OAK FOREST LN
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-9795
Practice Address - Country:US
Practice Address - Phone:843-839-6609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOPT.2215152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist