Provider Demographics
NPI:1568152676
Name:GRAY, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
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 1:11655 SOLAR CIR APT 7303
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7363
Mailing Address - Country:US
Mailing Address - Phone:520-404-2078
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80112-3276
Practice Address - Country:US
Practice Address - Phone:303-373-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant