Provider Demographics
NPI:1457685059
Name:GRAY, LINDA RACHELLE (APN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:RACHELLE
Last Name:GRAY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 515
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-666-6100
Mailing Address - Fax:501-666-6107
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-666-6100
Practice Address - Fax:501-666-6107
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03260363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner