Basic Information
| Provider Information | |||||||||
| NPI: | 1245686450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAY | ||||||||
| FirstName: | GABRIELLE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MSN, APRN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 71 HIGHLAND ST | ||||||||
| Address2: | DARTMOUTH HITCHCOCK-PEDIATRICS | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032641233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035363700 | ||||||||
| FaxNumber: | 6035365384 | ||||||||
| Practice Location | |||||||||
| Address1: | 71 HIGHLAND ST | ||||||||
| Address2: | DARTMOUTH HITCHCOCK-PEDIATRICS | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032641233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035363700 | ||||||||
| FaxNumber: | 6035365384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2016 | ||||||||
| LastUpdateDate: | 05/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 062978-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.