Individual
MARTA R GRAY
Active
Individual
MARTA R GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
2003018738
MO
363LF0000X
Family Nurse Practitioner
Primary
2003018738
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003018738
MO DIVISION OF PROFESSIONAL REGISTRATION - RN AND APRN LICENSE NUMBER
MO
Enumeration date
12/05/2007
Last updated
08/07/2020
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