Individual
KATHLEEN E GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1636 SHADOWOOD LN STE 120, JACKSONVILLE, FL 32207-2187
(904) 725-9701
(904) 725-9694
Mailing address
PO BOX 19249, JACKSONVILLE, FL 32245-9249
(904) 743-1883
(904) 743-5109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ARNP2844802
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP2844802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7663463
—
FL
Enumeration date
03/20/2012
Last updated
02/16/2022
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