Individual
MRS. JEANINE AIMEE GRAY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1960 KOELSCH CIR, APARTMENT D, HONOLULU, HI 96818-3538
(808) 422-7764
Mailing address
1960 D KOELSCH CIR, HONOLULU, HI 96818
(808) 422-7764
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN065251
GA
Other
Enumeration date
01/09/2006
Last updated
07/08/2007
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