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General NPI Number Information
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NPI Number | 1043109432
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Entity Type | Individual
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Provider Name | KIRA ANNETT GRAY APRN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 506 LITTLE CREEK CUT OFF RD
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City | SHERIDAN
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State | AR
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Zip | 72150-7798
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Country | US
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Telephone | 870-942-3000
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Fax | 870-942-3005
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Provider Business Mailing Address
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Address Line | 342 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4612
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Country | US
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Telephone | 870-723-4145
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Fax | 501-712-1447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06251953
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License Number State | AR
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