Provider Demographics
NPI:1922372838
Name:GRAYER, JENNIFER LYN (NNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYN
Last Name:GRAYER
Suffix:
Gender:F
Credentials:NNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 GREEN VALLEY RD
Mailing Address - Street 2:NICU-2ND FLOOR
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7021
Mailing Address - Country:US
Mailing Address - Phone:336-832-6865
Mailing Address - Fax:
Practice Address - Street 1:801 GREEN VALLEY RD
Practice Address - Street 2:NICU-2ND FLOOR
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7021
Practice Address - Country:US
Practice Address - Phone:336-832-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC930225363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care