Basic Information
| Provider Information | |||||||||
| NPI: | 1801332762 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAY | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DNP, WHNP, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6001 | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581086001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013648000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 425 7TH ST NW | ||||||||
| Address2: | |||||||||
| City: | CASS LAKE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 566333360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183353200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2017 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | CNP 4946 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.