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Individual

BERNADETTE GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
165 MARY ST, LAWRENCEBURG, IN 47025-1921
(812) 584-4563
Mailing address
9421 ACACIA PSGE, FORT WAYNE, IN 46835-9101
(260) 580-0029

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71010091A
IN

Other

Enumeration date
06/09/2020
Last updated
06/09/2020
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