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General NPI Number Information
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NPI Number | 1447116736
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Entity Type | Organization
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Legal Business Name | TRACI GRAY, NURSE PRACTITIONER INC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 307 CARPENTER ST
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City | JENA
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State | LA
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Zip | 71342-7143
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Country | US
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Telephone | 318-452-8650
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Fax | 318-992-8473
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Provider Business Mailing Address
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Address Line | 9663 HIGHWAY 84 E
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City | JENA
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State | LA
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Zip | 71342-5435
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Country | US
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Telephone | 318-316-2722
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Fax | 318-257-1468
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Authorized Official
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Title or Position | PWNER
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Name | TRACI GRAY
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Credential | APRN
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Telephone | 318-481-5724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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