Individual
LENISE MAE GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1428
Mailing address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1428
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
904759
MS
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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