| Doctor Name: | MARY JO RAY |
| NPI Number: | 1396748901 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 041-138505 |
| Business Practice Address: | 400 N 17th St Keokuk, IA - 526323452 |
| Business Phone Number: | 3195245734 |
| Business Fax Number: | 3195245758 |
| Mailing Address: | 400 N 17th St, KEOKUK |
| State: | IA |
| Postal Code: | 526323452 |
| Phone Number: | 3195245734 |
| Fax Number: | 3195245758 |
| NPI Enumeration Date: | 05/27/2005 |
| NPI Last Update Date: | 09/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 041-138505 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |