Provider Demographics
NPI:1447460704
Name:HRAY, JAMIE KIRSTEN
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:KIRSTEN
Last Name:HRAY
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 1:2908 EVONSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4637
Mailing Address - Country:US
Mailing Address - Phone:770-815-1675
Mailing Address - Fax:
Practice Address - Street 1:2908 EVONSHIRE LN
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4637
Practice Address - Country:US
Practice Address - Phone:770-815-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator