Provider Demographics
NPI:1043109432
Name:GRAY, KIRA ANNETT (APRN)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:ANNETT
Last Name:GRAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 HIGHWAY 425 S
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-4612
Mailing Address - Country:US
Mailing Address - Phone:870-723-4145
Mailing Address - Fax:501-712-1447
Practice Address - Street 1:506 LITTLE CREEK CUT OFF RD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-7798
Practice Address - Country:US
Practice Address - Phone:870-942-3000
Practice Address - Fax:870-942-3005
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARF06251953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily