Most Relevant Information
Provider Data
| NPI Number: | 1003654179 |
| Provider Name: | KIMBERLY NICOLE GRAY PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 0001242681 |
Most Important Dates
| Enumeration Date: | 07/15/2024 |
| Last Updated: | 08/06/2024 |
Provider Practice Location
825 FAIRFAX AVE STE 410
NORFOLK
VA
235071914
Practice Location Phone/Fax
| Phone: | 7574468999 |
| Fax: |
Provider Mailing Location
825 FAIRFAX AVE STE 410
NORFOLK
VA
235071914
Provider Mailing Phone/Fax
| Phone: | 7574468999 |
| Fax: |