Gray, Andrea B
Gray, Andrea B is an individual health care provider with primary practice located at 823 Park East Blvd Ste H , Lafayette IN 47905-0811. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Gray, Andrea B can be contacted via phone (765) 448-6226.Contact Information
Primary practice address
823 Park East Blvd Ste H
Lafayette IN 47905-0811
Phone: (765) 448-6226
Fax: (765) 448-9416
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 23002183A | Indiana |
Profile Details
| NPI number | 1336108612 |
|---|---|
| LBN Legal business name | Gray, Andrea B |
| Credentials | MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Jun 2nd, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336108612 | NPPES |
| Indiana | Other | 000000179545 | ANTHEM PROVIDER NUMBER |
| Indiana | MEDICAID | 200180390 | ANTHEM PROVIDER NUMBER |
| Indiana | MEDICAID | HA57500064 | ANTHEM PROVIDER NUMBER |
| Indiana | Other | 9397785 | ANTHEM PROVIDER NUMBER |
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