Provider Demographics
NPI:1902859192
Name:MAYS, LUCILLE (ARNP)
Entity Type:Individual
Prefix:
First Name:LUCILLE
Middle Name:
Last Name:MAYS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1098
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351
Mailing Address - Country:US
Mailing Address - Phone:606-783-6400
Mailing Address - Fax:606-783-6877
Practice Address - Street 1:1028 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1328
Practice Address - Country:US
Practice Address - Phone:606-783-6400
Practice Address - Fax:606-783-6877
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003621363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78016581Medicaid
KY78016581Medicaid