Individual
REBECCA LYNNE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092
(651) 982-7600
Mailing address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2615-33
WI
363L00000X
Nurse Practitioner
Primary
303
MN
363LF0000X
Family Nurse Practitioner
Primary
4514
MN
363LW0102X
Women's Health Nurse Practitioner
2615
WI
367A00000X
Advanced Practice Midwife
303
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106194
STATE MEDICAL LICENSE
WI
01
—
2615
STATE MEDICAL LICENSE
WI
01
—
38168
STATE MEDICAL LICENSE
MT
05
—
41265200
—
WI
01
—
R118279-4
STATE MEDICAL LICENSE
MN
Enumeration date
06/20/2006
Last updated
02/18/2026
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