Individual
KELLIE DENISE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6925 LA-74, ST. GABRIEL, LA 70776
(225) 642-3306
Mailing address
6925 LA-74, ST. GABRIEL, LA 70776
(225) 642-3306
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09561
LA
Other
Enumeration date
08/14/2017
Last updated
02/17/2021
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