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General NPI Number Information
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NPI Number | 1386517613
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Entity Type | Organization
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Legal Business Name | GRAYER PROFESSIONAL NURSING SERVICES
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 4211 NW HIGHWAY 550
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City | UNION CHURCH
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State | MS
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Zip | 39668-7012
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Country | US
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Telephone | 601-754-5513
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Fax |
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Provider Business Mailing Address
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Address Line | 747 INDUSTRIAL PARK RD NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2065
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Country | US
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Telephone | 601-754-5513
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | BRENILLA VAUGHN
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Credential | NP-C
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Telephone | 601-754-5513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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