Individual
KRISTYNE L. GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP.
Contact information
Practice address
1001 W 10TH ST, INDIANAPOLIS, IN 46202-2859
(317) 808-0573
Mailing address
PO BOX 78158, INDIANAPOLIS, IN 46278-0158
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000706A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200426980
—
IN
Enumeration date
05/17/2006
Last updated
12/31/2012
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