Individual
TRACI GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
307 CARPENTER ST, JENA, LA 71342-7143
(318) 481-5724
(318) 257-1468
Mailing address
307 CARPENTER ST, JENA, LA 71342-7143
(318) 481-5724
(318) 257-1468
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
206362
LA
363LP2300X
Primary Care Nurse Practitioner
206362
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2512161
—
LA
Enumeration date
06/14/2019
Last updated
12/18/2025
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