Healthcare Provider Details

I. General information

NPI: 1629387592
Provider Name (Legal Business Name): KATHRYN LYNN CRAY C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W CENTRAL AVE STE 100
TOLEDO OH
43606-3817
US

IV. Provider business mailing address

100 MADISON AVE
TOLEDO OH
43604-1516
US

V. Phone/Fax

Practice location:
  • Phone: 419-537-5111
  • Fax: 419-537-5131
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number11808-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.11808-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: