Individual
TIFFANY GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
3086 SUNSET CT, COCOA, FL 32922-6657
(407) 619-5013
Mailing address
3086 SUNSET CT, COCOA, FL 32922-6657
(407) 619-5013
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11028549
FL
363LG0600X
Gerontology Nurse Practitioner
11028549
FL
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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