Gray, Stacy

Gray, Stacy is an individual health care provider with primary practice located at 620 S Laurel St , Pine Bluff AR 71601-4859. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Gray, Stacy can be contacted via phone (870) 534-4900.

Contact Information

Primary practice address
620 S Laurel St Pine Bluff AR 71601-4859
Phone: (870) 534-4900
Fax: (870) 534-4906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X R093057 Arkansas

Profile Details

NPI number 1114304862
LBN Legal business name Gray, Stacy
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2015
Last updated May 1st, 2015 - 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 1114304862 NPPES
Arkansas MEDICAID 180635526

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