Gray, Lisa Marie

Gray, Lisa Marie is an individual health care provider with primary practice located at 1650 Cochrane Cir , Fort Carson CO 80913-4613. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gray, Lisa Marie can be contacted via phone (719) 526-7061.

Contact Information

Primary practice address
1650 Cochrane Cir Fort Carson CO 80913-4613
Phone: (719) 526-7061
Fax: (719) 526-7132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 268905 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X C-APN.0000410-C-NP Colorado

Profile Details

NPI number 1326440439
LBN Legal business name Gray, Lisa Marie
Credentials DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2014
Last updated Sep 15th, 2016 - about 9 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 1326440439 NPPES
North Carolina MEDICAID 1326440439

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