Individual
MRS. DIANE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
646 WASHINGTON DR, JONESBORO, GA 30238-8516
(404) 964-0298
(770) 252-1102
Mailing address
646 WASHINGTON DRIVE, JONESBORO, GA 30238
(404) 964-0298
(770) 252-1102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN104383
GA
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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