Individual
JESSICA W GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 VIRGINIA ST E STE 400, CHARLESTON, WV 25301-2835
(681) 313-4759
(844) 800-3954
Mailing address
288 MOFFIT RD, DILLINER, PA 15327-2614
(724) 833-1293
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41726
WV
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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