MEDICARE: JOUVONNA LYNETTE GRAY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP127938	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821328949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOUVONNA LYNETTE GRAY FNP

Provider Business Mailing Address
First Line	:	19020 W LAKE HOUSTON PKWY
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-5131
Country	:	US
Telephone Number	:	281-812-3736
Fax Number	:	844-781-2056

Provider Business Practice Location Address
First Line	:	19020 W LAKE HOUSTON PKWY
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-5131
Country	:	US
Telephone Number	:	281-812-3736
Fax Number	:	844-781-2056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	07/11/2022

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