Individual
NATASHA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
18699 N 67TH AVE STE 120, GLENDALE, AZ 85308-7141
(888) 402-7256
Mailing address
15564 229TH ST, BOX ELDER, SD 57719-8032
(605) 209-0301
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001268
SD
363L00000X
Nurse Practitioner
TEMP308456
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP001268
SD BON
SD
Enumeration date
09/19/2017
Last updated
06/20/2024
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