Gray, Susan M

Gray, Susan M is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. 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, Susan M can be contacted via phone (218) 786-6244.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R072543-7 Minnesota

Profile Details

NPI number 1609820943
LBN Legal business name Gray, Susan M
Credentials RN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated May 17th, 2011 - about 13 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 1609820943 NPPES
Wisconsin MEDICAID 43947100
Wisconsin MEDICAID 160123700

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