Provider Demographics
NPI:1770044109
Name:GRAY, FRANCES VIVIAN BERSCAK (PA)
Entity type:Individual
Prefix:MISS
First Name:FRANCES
Middle Name:VIVIAN BERSCAK
Last Name:GRAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:VIVIAN
Other - Last Name:BERSCAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:11803 JEFFERSON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2565
Mailing Address - Country:US
Mailing Address - Phone:757-736-9860
Mailing Address - Fax:757-240-5537
Practice Address - Street 1:11803 JEFFERSON AVE STE 205
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2565
Practice Address - Country:US
Practice Address - Phone:757-736-9860
Practice Address - Fax:757-240-5537
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0110006743363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program