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General NPI Number Information
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NPI Number | 1528603099
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Entity Type | Individual
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Provider Name | BETH GRAY NP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 8580 SCARBOROUGH DR STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7583
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Country | US
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Telephone | 719-596-3344
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Fax | 719-632-6118
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Provider Business Mailing Address
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Address Line | 16760 PRAIRIE VISTA LN
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City | PEYTON
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State | CO
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Zip | 80831-8647
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Country | US
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Telephone | 719-231-0724
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 0995095
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0995095
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN.0995095-NP
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License Number State | CO
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