Gray-Millenbaugh Practitioner Healthcare, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

A002944 Issued in AR

Legal business name

GRAY-MILLENBAUGH PRACTITIONER HEALTHCARE, LLC

Practice address

3801 Camden Rd
Chapel Village 1 Suite 12
Pine Bluff, AR 71603-4612

Phone

(870) 534-4847

Fax

(870) 534-4884

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Diana Gray Millenbaugh, MSN, APRN, BC

Title

Owner

Phone

(870) 329-4202

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1962883520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD",
            "address_2": "CHAPEL VILLAGE 1 SUITE 12",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-534-4847",
            "fax_number": "870-534-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD",
            "address_2": "CHAPEL VILLAGE 1 SUITE 12",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-534-4847",
            "fax_number": "870-534-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY-MILLENBAUGH PRACTITIONER HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "MILLENBAUGH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "GRAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-329-4202",
        "authorized_official_credential": "MSN, APRN, BC"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AR",
            "license": "A002944",
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "AR",
            "license": "A002944",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AR",
            "license": "A002944",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "A002944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• O T Gordon Jr., M.D.
• Jeffrey Tad Goss, PHARMD
• Shacoya Latrece Grady, LPN
• Rontae Marvell Edward Graham, DDS
• Rebecca Grandy, APN
• Stacy Gray, RN
• Arriel S Green, BS, MS, MHPP
• Hillary Green, LCSW
• Madison Green
• Nathan Green, MD

• Nursing Care Agency in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Nursing Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.