Provider Demographics
NPI:1144190661
Name:RAY, JAZZ-MINE
Entity type:Individual
Prefix:
First Name:JAZZ-MINE
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 DOWS ST
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:IA
Mailing Address - Zip Code:52227-9572
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2222 JOHNSON AVE NW STE 5
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-4762
Practice Address - Country:US
Practice Address - Phone:319-536-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula