Individual
JOVAN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 W CRAIG RD, SUITE B, N LAS VEGAS, NV 89032-5118
(702) 776-7772
Mailing address
3455 W CRAIG RD, SUITE B, N LAS VEGAS, NV 89032-5118
(702) 776-7772
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811325095
—
NV
Enumeration date
06/28/2014
Last updated
06/28/2014
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