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Individual

AMANDA BRENN GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10 ENTERPRISE BLVD STE 110, GREENVILLE, SC 29615-3534
(864) 609-4009
Mailing address
322 PIMLICO RD, GREENVILLE, SC 29607-3057

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25238
SC

Other

Enumeration date
08/02/2021
Last updated
08/09/2021
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