Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | GRAY-ECRL35 | NC |
NPI | 1003267469 |
---|---|
Provider Name | Erin Abbey Gray |
First Address | Mooresville, NC 28117-8522 |
Second Address | Mooresville, NC 28117-8522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2016 |
Last Update Date | 28/06/2016 |