Gray, Kathryn Nicole

Gray, Kathryn Nicole is an individual health care provider with primary practice located at 3434 W Illinois Ave 306-3, Dallas TX 75211-8709. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Health Educator, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Gray, Kathryn Nicole can be contacted via phone (214) 623-1900.

Contact Information

Primary practice address
3434 W Illinois Ave 306-3 Dallas TX 75211-8709
Phone: (214) 623-1900
Fax: (214) 623-1901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X 717114 Texas
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 717114 Texas

Profile Details

NPI number 1508151994
LBN Legal business name Gray, Kathryn Nicole
Credentials RN, CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2011
Last updated Oct 25th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508151994 NPPES
Texas MEDICAID 1775835-03

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