MEDICARE: BRITTANY GRAY RN

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	163W00000X	Registered Nurse	RN.535533	OH

General Provider Information

NPI Number	:	1871330696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY GRAY RN

Provider Business Mailing Address
First Line	:	3743 WILLOW RUN DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2648
Country	:	US
Telephone Number	:	567-686-5780
Fax Number	:

Provider Business Practice Location Address
First Line	:	3743 WILLOW RUN DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2648
Country	:	US
Telephone Number	:	567-686-5780
Fax Number	:

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

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	07/10/2024

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