Healthcare Provider Details

I. General information

NPI: 1801577374
Provider Name (Legal Business Name): GREY MARIA DICKINSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GREY MARIA OBREGON CRNA

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GEORGE ST
YORK PA
17403-3676
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-7687
  • Fax: 717-851-5250
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN743000
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN743000
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: