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Individual
BENNIE B GRAY
Active
Individual
BENNIE B GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-36340-111
KS
363LF0000X
Family Nurse Practitioner
44008
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00266942
RR MEDICARE
—
Enumeration date
08/19/2006
Last updated
09/11/2025
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