Most Relevant Information
Provider Data
| NPI Number: | 1003531518 |
| Provider Name: | MARINA GRAY APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 222081 |
Most Important Dates
| Enumeration Date: | 10/06/2022 |
| Last Updated: | 12/01/2023 |
Provider Practice Location
495 HOGAN LN STE 2
CONWAY
AR
720348498
Practice Location Phone/Fax
| Phone: | 5013586695 |
| Fax: | 5013586860 |
Provider Mailing Location
PO BOX 9662
CONWAY
AR
720339662
Provider Mailing Phone/Fax
| Phone: | 5018521363 |
| Fax: |