Individual
MRS. JAIMIE MICHELLE GRAY-O'BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
95 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-7001
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F339709
NY
363LF0000X
Family Nurse Practitioner
F339709
NY
Other
Enumeration date
06/15/2015
Last updated
10/19/2020
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