Individual
KATHRYN A GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., F.N.P.
Contact information
Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6520
(231) 935-9116
Mailing address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6520
(231) 935-9116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704116935
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3521244
—
MI
01
—
4704116935
LICENSE
MI
01
—
500B814150
BLUE CROSS GROUP PRACTICE PIN
MI
Enumeration date
06/01/2006
Last updated
03/07/2023
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