Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 1363 | HI |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1363 | HI |
NPI | 1033497813 |
---|---|
Provider Name | Ms. Rebecca Shawn Gray |
First Address | Waialua, HI 96791-0635 |
Second Address | Kapolei, HI 96707-2028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2011 |
Last Update Date | 22/11/2016 |