Gray, Stephanie M

Gray, Stephanie M is an individual health care provider with primary practice located at 10 Goodall Dr , East Waterboro ME 04030-5214. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gray, Stephanie M can be contacted via phone (207) 490-7760.

Contact Information

Primary practice address
10 Goodall Dr East Waterboro ME 04030-5214
Phone: (207) 490-7760
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1092 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1416 Maine

Profile Details

NPI number 1922440361
LBN Legal business name Gray, Stephanie M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2013
Last updated Jun 25th, 2019 - about 7 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 1922440361 NPPES
New Hampshire MEDICAID 3102665

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