Individual
KIMECA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1631 E 2ND ST, AUSTIN, TX 78702-4490
(512) 703-1365
Mailing address
213 ARABIAN COLT DR, GEORGETOWN, TX 78626-2655
(254) 371-0933
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
967202
TX
164W00000X
Licensed Practical Nurse
219741
TX
Other
Enumeration date
12/29/2015
Last updated
06/11/2024
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