Provider Demographics
NPI:1770275406
Name:VERITY, GRAYSON SHEA (FNP)
Entity type:Individual
Prefix:
First Name:GRAYSON
Middle Name:SHEA
Last Name:VERITY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 BOCA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-2611
Mailing Address - Country:US
Mailing Address - Phone:407-539-4300
Mailing Address - Fax:
Practice Address - Street 1:2609 S ORANGE AVE STE 110
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4533
Practice Address - Country:US
Practice Address - Phone:407-641-2444
Practice Address - Fax:407-200-2392
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily