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General NPI Number Information
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NPI Number | 1255863817
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Entity Type | Individual
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Provider Name | WILLIAM HENRY GRAY III RN
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Gender | Male
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 920 VARNUM ST NE
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City | WASHINGTON
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State | DC
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Zip | 20017-2145
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Country | US
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Telephone | 202-854-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 4407 FESSENDEN ST NW
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City | WASHINGTON
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State | DC
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Zip | 20016-4065
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Country | US
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Telephone | 804-677-6924
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 0001236100
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | RN1055366
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN1055366
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License Number State | DC
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