Individual
CARRIE JEAN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
911 MARYLAND AVE E, SAINT PAUL, MN 55106-2697
(651) 776-2719
(651) 771-3978
Mailing address
2025 SLOAN PL, SUITE 35, SAINT PAUL, MN 55117-2007
(651) 772-1572
(651) 772-1889
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10404
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
958157000
—
MN
Enumeration date
03/23/2006
Last updated
10/27/2011
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