Individual
MRS. MARY HELEN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., N.P
Contact information
Practice address
5775 WAYZAYA BLVD, SUITE 190, ST. LOUIS PARK, MN 55416
(952) 738-4623
Mailing address
5775 WAYZATA BLVD STE 190, ST LOUIS PARK, MN 55416-2627
(952) 738-4623
(952) 738-4622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 149240 0
MN
363LA2200X
Adult Health Nurse Practitioner
Primary
2006005436
MN
Other
Enumeration date
06/03/2006
Last updated
08/16/2018
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