Individual
CARRIE HORTON GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-1848
(601) 376-1894
Mailing address
PO BOX 23894, JACKSON, MS 39225-3894
(601) 376-1848
(601) 376-1894
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R877355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04126767
—
MS
Enumeration date
01/12/2012
Last updated
02/10/2016
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