Healthcare Provider Details

I. General information

NPI: 1285170399
Provider Name (Legal Business Name): BREANNE MICHELLE GRAY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BREANNE MICHELLE GIRON RN

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 FRIENDSHIP AVE
PITTSBURGH PA
15224-1722
US

IV. Provider business mailing address

3949 LOGANS FERRY RD
MONROEVILLE PA
15146-1249
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-5858
  • Fax:
Mailing address:
  • Phone: 724-822-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberSP017071
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberSP017071
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: