Lenise Mae Grayson, BSN, RN
Registered Nurse, General Practice in Gallup, NM. Individual provider (NPI-1).
NPI number1568094035
StatusActive
Last updated in NPPESFeb 12, 2020
Details
- NPI
- 1568094035
- Entity type
- Individual (NPI-1)
- Name
- Lenise Mae Grayson
- Credential
- BSN, RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 12, 2020
- Certification date
- Feb 12, 2020
- Last updated
- Feb 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | 904759 | MS | Yes |
Practice location
516 E Nizhoni BlvdGallup, NM 87301-5748
Phone 505-722-1428
Mailing address
516 E Nizhoni BlvdGallup, NM 87301-5748
Phone 505-722-1428
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