Provider Demographics
NPI:1023126257
Name:GRAY, PATRICIA LYNN (RNC, WHNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:GRAY
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 DENNIS STREET
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-3331
Mailing Address - Country:US
Mailing Address - Phone:517-442-8030
Mailing Address - Fax:517-266-7804
Practice Address - Street 1:LENAWEE COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:1040 SOUTH WINTER SUITE 2328
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221
Practice Address - Country:US
Practice Address - Phone:517-264-5233
Practice Address - Fax:517-266-7804
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704178704363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health