Individual
MICHAEL SHANE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
10755 EAGLE WAY, HOPKINSVILLE, KY 42240-8742
(270) 887-0270
Mailing address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3018060
KY
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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