Provider Demographics
NPI:1780649749
Name:RAYHILL, MARY ANGELA (APRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANGELA
Last Name:RAYHILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANGELA
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:300 HIGH POINT CT
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-6560
Practice Address - Country:US
Practice Address - Phone:502-955-6129
Practice Address - Fax:502-955-8164
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003757363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000052154HOtherHUMANA - NMA
KY50003388OtherPASSPORT & PASSPORT ADVANTAGE - NMA
KY000000350669OtherANTHEM - NMA
KY78011665Medicaid
KY035357OtherSIHO - NMA
KYP00181606Medicare PIN
KY50003388OtherPASSPORT & PASSPORT ADVANTAGE - NMA
KY035357OtherSIHO - NMA