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Individual

TRENTON D GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Mailing address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11513298-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639692510
UT
Enumeration date
07/21/2017
Last updated
05/02/2024
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