Provider Demographics
NPI:1740284116
Name:MAY, ANN (NP-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0457
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5031
Practice Address - Street 1:2501 VALLEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-6339
Practice Address - Country:US
Practice Address - Phone:540-862-4146
Practice Address - Fax:540-862-0131
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001102429363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010293553Medicaid
VA010293553Medicaid
VA00W117W01Medicare ID - Type UnspecifiedTRAILBLAZER HEALTH/VAMC