Provider Demographics
NPI:1699400747
Name:GREY, KERRI ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:ANN
Last Name:GREY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:GLENS FALLS HOSPITAL- CREDENTIALING
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801
Mailing Address - Country:US
Mailing Address - Phone:518-926-5924
Mailing Address - Fax:
Practice Address - Street 1:79 NORTH STREET
Practice Address - Street 2:GRANVILLE MEDICAL CENTER
Practice Address - City:GRANVILLE
Practice Address - State:NY
Practice Address - Zip Code:12832
Practice Address - Country:US
Practice Address - Phone:518-642-0612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY598367163WG0000X
NYF349822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice