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Individual

LASHONDA GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
611 W. PARK ST, URBANA, IL 61801-2500
(217) 383-3303
(217) 383-3265
Mailing address
611 W. PARK ST, BWPC, URBANA, IL 61801-2500
(217) 383-6941
(217) 383-4752

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209011207
IL
367500000X
Certified Registered Nurse Anesthetist
RN595726
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
087244
CRNA CERTIFICATION
PA
01
RN595726
RN LICENSE
PA
Enumeration date
04/05/2011
Last updated
08/25/2025
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