Individual
MRS. KIMBERLY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4111 S 108TH ST, GREENFIELD, WI 53228-1905
(262) 716-5326
Mailing address
30815 ROYAL HILL RD, BURLINGTON, WI 53105-7762
(262) 716-5326
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11507-33
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/01/2021
Last updated
10/29/2021
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