Individual
JANNYSSE ELIZABETH GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
4580 S LINDBERGH BLVD, SOUTH COUNTY HEALTH CENTER, SAINT LOUIS, MO 63127-1810
(314) 842-1300
(314) 842-6431
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
2005032433
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17378
EMPLOYEE ID
MO
Enumeration date
12/21/2006
Last updated
11/20/2024
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