Individual
LAQUACIOUS MCCRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501
(707) 268-2990
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95316778
CA
164W00000X
Licensed Practical Nurse
PN5200746
FL
Other
Enumeration date
02/29/2012
Last updated
10/27/2023
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