Active NPI
Kellie Denise Gray, FNP-C
- Family Nurse Practitioner
- Saint Gabriel, LA
National Provider Identifier
1619493418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP09561
- Practice address
- 6925 La-74
St. Gabriel, LA 70776 - Phone
- (225) 642-3306
- NPI assigned
- Aug 14, 2017
- Last updated
- Feb 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP09561 | LA | Primary |
Addresses
Primary practice location
6925 La-74
St. Gabriel, LA 70776
Mailing address
6925 La-74
St. Gabriel, LA 70776
Phone (225) 642-3306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP09561 | LA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1619493418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6925 LA-74",
"city": "ST. GABRIEL",
"state": "LA",
"postal_code": "70776",
"telephone_number": "225-642-3306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6925 LA-74",
"city": "ST. GABRIEL",
"state": "LA",
"postal_code": "70776",
"telephone_number": "225-642-3306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "KELLIE",
"middle_name": "DENISE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-14",
"last_updated": "2021-02-17",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP09561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Gabriel, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.