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NPI Code Detail

MEDICARE: NANCY S GRAY NP

MEDICARE: NANCY S GRAY NP
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
1363L00000XNurse Practitioner11213TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24141501OTHERTNBCBS

General Provider Information

NPI Number : 1871536789
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY S GRAY NP
Provider Business Mailing Address
First Line : PO BOX 24730
Second Line :
City : NASHVILLE
State : TN
Zip : 37202
Country : US
Telephone Number : 615-386-2300
Fax Number : 615-386-2399
Provider Business Practice Location Address
First Line : 5201 CHARLOTTE AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-3320
Country : US
Telephone Number : 615-222-1900
Fax Number : 615-222-1917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 02/02/2009

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