Individual
IVY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1000
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23676
SC
Other
Enumeration date
06/09/2020
Last updated
04/26/2021
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