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Individual

MS. SUSAN M GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CNP

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-6244
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-6244

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R072543-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
160123700
MN
05
43947100
WI
Enumeration date
05/20/2006
Last updated
05/17/2011
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