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General NPI Number Information
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NPI Number | 1679945687
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Entity Type | Individual
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Provider Name | ALICIA LYNN GRAY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/29/2015
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 5601 ARRINGDON PARK DR STE 150
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City | MORRISVILLE
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State | NC
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Zip | 27560-5643
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Country | US
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Telephone | 919-570-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 5213 S ALSTON AVE
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City | DURHAM
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State | NC
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Zip | 27713-4430
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Country | US
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Telephone | 919-620-4855
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5008150
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5008150
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License Number State | NC
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