Individual
MRS. DIAN SUDENE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
803 BELSLY BLVD, MOORHEAD, MN 56560-5057
(218) 236-7145
Mailing address
803 BELSLY BLVD, MOORHEAD, MN 56560-5057
(218) 236-7145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11035448
FL
363LF0000X
Family Nurse Practitioner
Primary
13709
MN
Other
Enumeration date
09/24/2024
Last updated
03/25/2026
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