Deanna Lynn Gray-Miceli, PHD., GNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NN07764000 Issued in NJ

Practice address

870 E Route 70
Marlton, NJ 08053-5566

Phone

(609) 790-2327

Fax

(856) 703-3000

NPI assigned

Oct 18, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Fall Prevention Group, LLC

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
  • NPI 1134529118
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1710213251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2032",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080330795",
            "telephone_number": "609-790-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 E ROUTE 70",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535566",
            "telephone_number": "609-790-2327",
            "fax_number": "856-703-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-MICELI",
        "first_name": "DEANNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD., GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-18",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NN07764000",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "TP000803H",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lynn Gould-Grabarski, MA, CCC-SLP
• Stuart D Gould, M.D.
• Kathryn A Grady, D.D.S., M.S.
• Charles Graham, MSW
• Malvina Granovskaya, MS CCC-SLP
• Greater New Jersey Creative Counseling
• Greater New Jersey Creative Counseling Inc
• Anthony Greco, CRNA
• Justin Jacob Green, MD
• Adele Greenhaus, LCSW

• Gerontology Nurse Practitioner in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.