Provider Demographics
NPI:1306997275
Name:MAY, DORIS ANN (CNS)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:MAY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8923
Mailing Address - Country:US
Mailing Address - Phone:317-272-3330
Mailing Address - Fax:317-272-0807
Practice Address - Street 1:6655 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8923
Practice Address - Country:US
Practice Address - Phone:317-272-3330
Practice Address - Fax:317-272-0807
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70000042A364SS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SS0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100270530AMedicaid
IN100270530AMedicaid