Individual
SHELLEY LENORE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
900 TOWNE LAKE PKWY, STE 404, WOODSTOCK, GA 30189-1602
(770) 926-9229
(678) 415-2164
Mailing address
900 TOWNE LAKE PKWY, STE 404, WOODSTOCK, GA 30189-1602
(770) 926-9229
(678) 415-2164
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN124867
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000876213A
—
GA
05
—
000876213E
—
GA
05
—
000876213F
—
GA
01
—
10045510
AMERIGROUP
GA
01
—
340885
WELLCARE
GA
Enumeration date
07/17/2006
Last updated
02/17/2020
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