Individual
ANGELA JO GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272
Taxonomy
Speciality
Code
Description
License number
State
207VC0300X
Complex Family Planning Physician
1205242120
IL
363LF0000X
Family Nurse Practitioner
Primary
209022716
IL
Other
Enumeration date
10/17/2022
Last updated
06/11/2024
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