Individual
DOMINIQUEKAL BROWN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8032C LIBERTY RD, FREDERICK, MD 21701-3239
(301) 846-0090
Mailing address
8032C LIBERTY RD, FREDERICK, MD 21701-3239
(301) 846-0090
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
903216
MS
363LF0000X
Family Nurse Practitioner
Primary
AC003096
MD
Other
Enumeration date
07/19/2019
Last updated
06/03/2020
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