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General NPI Number Information
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NPI Number | 1780920553
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Entity Type | Individual
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Provider Name | MEGHAN ELIZABETH GRAY N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2012
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 1963 MCDOWELL ROAD
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City | JACKSON
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State | MS
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Zip | 39296
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Country | US
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Telephone | 601-372-3632
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Fax | 601-372-7361
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Provider Business Mailing Address
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Address Line | 29 MOSS WOODS CV
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City | MADISON
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State | MS
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Zip | 39110-9164
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Country | US
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Telephone | 601-720-6800
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R877503
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License Number State | MS
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