Individual
KRISTIN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
Mailing address
1845 HARMONY HEIGHTS LN, APT #104, RAPID CITY, SD 57702-6245
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043083321
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140070
—
SD
05
—
5549050
—
SD
Enumeration date
10/31/2011
Last updated
10/31/2011
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