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General NPI Number Information
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NPI Number | 1225730591
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Entity Type | Individual
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Provider Name | TRENTON GRAY CLAYTON ACNP
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Gender | Male
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 2100 STANTONSBURG RD
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City | GREENVILLE
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State | NC
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Zip | 27834-2818
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Country | US
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Telephone | 252-945-5135
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 STANTONSBURG RD
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City | GREENVILLE
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State | NC
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Zip | 27834-2818
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Country | US
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Telephone | 252-847-4100
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 313517
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5021008
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License Number State | NC
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