Individual
RANDALL GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1229 LINCOLN ST, ANDERSON, IN 46016-1693
(765) 313-9850
(765) 649-9185
Mailing address
729 W 4TH ST APT 1, ANDERSON, IN 46016-1197
(765) 639-5788
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28158270C
IN
Other
Enumeration date
01/20/2025
Last updated
10/07/2025
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