Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0000018270 | TN |
NPI | 1023434248 |
---|---|
Provider Name | Ms. Deborah Pearson Gray |
First Address | Hendersonville, TN 37207 |
Second Address | Gallatin, TN 37066-8564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2014 |
Last Update Date | 25/11/2014 |