Individual
TRACEY GRAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 364-5159
Mailing address
PO BOX 545, MADISON, MS 39130-0545
(770) 546-6270
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
905260
MS
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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