NPI | 1366778144 |
---|---|
Former Name | REBECCA SUE GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006742) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A03265ANP) |
363LF0000X Nurse Practitioner, Family (Licence: TN APN0000014292) | |
Enumeration Date | 2009-10-28 |
Last Update Date | 2024-08-27 |