Individual
WYLEA MARIE GRAY-WINFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1217 WILLOW GLEN RIVER RD, ALEXANDRIA, LA 71302-5454
(318) 487-4400
Mailing address
1217 WILLOW GLEN RIVER RD, ALEXANDRIA, LA 71302-5454
(318) 487-4400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
PA020344
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1112585
—
LA
01
—
AP03533
ADVANCE PRACTICE RN
LA
Enumeration date
05/14/2007
Last updated
07/08/2007
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