Provider Demographics
NPI:1598499204
Name:MAY, CHRISTIE KAYE
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:KAYE
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 1:3012 CALIFORNIA HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:45612-9713
Mailing Address - Country:US
Mailing Address - Phone:740-222-5435
Mailing Address - Fax:
Practice Address - Street 1:3012 CALIFORNIA HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:45612-9713
Practice Address - Country:US
Practice Address - Phone:740-222-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH112936164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse