Provider Demographics
NPI:1275253197
Name:GRAY, ELANA DENEAN
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:DENEAN
Last Name:GRAY
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 1:5311 GRAFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-5811
Mailing Address - Country:US
Mailing Address - Phone:513-391-4106
Mailing Address - Fax:
Practice Address - Street 1:5311 GRAFTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-5811
Practice Address - Country:US
Practice Address - Phone:513-391-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide