Individual
DR. DEANNA LYNN GRAY-MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD., GNP-BC
Contact information
Practice address
870 E ROUTE 70, MARLTON, NJ 08053-5566
(609) 790-2327
(856) 703-3000
Mailing address
PO BOX 2032, HADDONFIELD, NJ 08033-0795
(609) 790-2327
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NN07764000
NJ
363LG0600X
Gerontology Nurse Practitioner
TP000803H
PA
Other
Enumeration date
10/18/2009
Last updated
02/24/2011
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