Provider Demographics
NPI:1043924749
Name:GRAY, LINDA MARGARET (LVN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARGARET
Last Name:GRAY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N JUDGE ELY BLVD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5553
Mailing Address - Country:US
Mailing Address - Phone:325-400-8586
Mailing Address - Fax:325-603-0507
Practice Address - Street 1:429 N JUDGE ELY BLVD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5553
Practice Address - Country:US
Practice Address - Phone:325-400-8586
Practice Address - Fax:325-603-0507
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123912164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse