Individual
MRS. NANETTE L GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7408 W STATE ROAD 28 STE 1, ELWOOD, IN 46036-8601
(765) 501-8566
Mailing address
7408 W STATE ROAD 28 STE 1, ELWOOD, IN 46036-8601
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000354A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343305
BLUE CROSS
IN
05
—
200506240A
—
IN
Enumeration date
10/14/2006
Last updated
10/05/2022
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