Bradley Thomas Gray, RN
Individual provider Active NPI Registered Nurse · Grey Eagle, MN
NPI 1659948974 · NPPES record last updated Apr 26, 2022
Key facts
- NPI
- 1659948974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 2493855 (MN)
- Practice address
- 11114 Almond Dr
Grey Eagle, MN 56336-4643 - Phone
- (605) 413-7349
- NPI assigned
- Jun 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2493855 | MN | MD | Registered Nurse |
| 763648 | MN | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adapt Kare Choices Corporation | Current | Accepting new patients | |
| Additional Kare for Kids, Inc | Current | Accepting new patients | |
| Additional Kare for Kids, Inc. | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 763648 | MN | |
| Registered Nurse | 163W00000X | 2493855 | MN | Yes |
Addresses
Primary practice location
11114 Almond Dr
Grey Eagle, MN 56336-4643
Mailing address
PO Box 156
Grey Eagle, MN 56336-0156
Phone (507) 475-4354
Other providers in Grey Eagle, MN
All providers in Grey Eagle, MN · Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.