Provider Demographics
NPI:1740893080
Name:CLAY, KRISTI LYNN
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LYNN
Last Name:CLAY
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 1:116 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WV
Mailing Address - Zip Code:25880-9468
Mailing Address - Country:US
Mailing Address - Phone:304-222-2180
Mailing Address - Fax:
Practice Address - Street 1:116 BENNETT HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:WV
Practice Address - Zip Code:25880
Practice Address - Country:US
Practice Address - Phone:304-222-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant