Individual
CAROL KOETHER GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
179 W CHESTNUT HILL RD, SUITE 1, NEWARK, DE 19713-2210
(302) 453-1343
(302) 453-1654
Mailing address
179 W CHESTNUT HILL RD, SUITE 1, NEWARK, DE 19713-2210
(302) 453-1343
(302) 453-1654
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
LG0000193
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001144842
—
DE
Enumeration date
07/02/2006
Last updated
07/08/2007
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