Individual
MARGO DIANE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10130 PERIMETER PKWY, STE 200, CHARLOTTE, NC 28216-2447
(888) 849-7379
(855) 857-7333
Mailing address
3046 CULLENS DR, GRAHAM, NC 27253-5407
(336) 214-5260
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3006128
KY
363LF0000X
Family Nurse Practitioner
5008662
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000639866
ANTHEM BLUECROSS
KY
01
—
000000731911
ANTHEM
KY
05
—
710096140
—
KY
Enumeration date
08/26/2009
Last updated
08/20/2020
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