Provider Demographics
NPI:1518331552
Name:WRAY, ELIZABETH ANDERSON (APRN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANDERSON
Last Name:WRAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANDERSON
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:1840 S 1300 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3697
Mailing Address - Country:US
Mailing Address - Phone:801-832-2239
Mailing Address - Fax:
Practice Address - Street 1:1840 S 1300 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3697
Practice Address - Country:US
Practice Address - Phone:801-832-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4311363L00000X
UT350460-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner