Tiffany Chanel Gray, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

196082 - 30 Issued in WI

Practice address

211 W Main St
Marshall, WI 53559-8964

Phone

(608) 658-0271

NPI assigned

May 17, 2013

Last updated

Jun 25, 2013By the provider in NPPES

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1790121671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6242",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537160242",
            "telephone_number": "608-658-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W MAIN ST",
            "city": "MARSHALL",
            "state": "WI",
            "postal_code": "535598964",
            "telephone_number": "608-658-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TIFFANY",
        "middle_name": "CHANEL",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "196082 - 30",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "31404531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Carmen Canon, D.C.
• Maxwell Clark
• Dane County EMS District No 14 (Marshall Area EMS c/o Marshall EMS District 14)
• Nikki Lee Frisch, RDH
• Laura Gillis, LPC
• Kim Lee Hackett, COTA
• Christine Haugen, RDH
• Kathleen Homan, RDH
• Lisa Huffer
• Denise M James, RN

• Registered Nurse in Marshall, WI
• Providers in Marshall, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.