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General NPI Number Information
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NPI Number | 1457288060
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Entity Type | Individual
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Provider Name | DEEANA GRAY
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Gender | Female
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 1420 HULL ST APT 235
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City | RICHMOND
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State | VA
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Zip | 23224-3959
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Country | US
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Telephone | 804-866-0868
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 HULL ST APT 235
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City | RICHMOND
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State | VA
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Zip | 23224-3959
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Country | US
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Telephone |
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | T4X8P8L8
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2470A2800X
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Taxonomy Name | Assistant Health Information Record Technician
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License Number | A7E3H6C4
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License Number State |
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