Individual
PATRICIA A. GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11590 N MERIDIAN ST, STE 300, CARMEL, IN 46032-4529
(317) 948-7450
(317) 688-5098
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28127287A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71002039
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200833890
—
IN
Enumeration date
10/02/2006
Last updated
01/19/2021
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