Individual
SHELLEY S WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2321 E GALA ST STE 3, MERIDIAN, ID 83642-7692
(208) 888-5848
(208) 888-0884
Mailing address
2321 E GALA ST STE 3, MERIDIAN, ID 83642-7692
(208) 888-5848
(208) 888-0884
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP-1476A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1746A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447649975
—
ID
Enumeration date
01/21/2015
Last updated
09/08/2023
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