Provider Demographics
NPI:1174729388
Name:GRAY, LATOYA NICOLE (CNA)
Entity type:Individual
Prefix:MISS
First Name:LATOYA
Middle Name:NICOLE
Last Name:GRAY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NA
Mailing Address - Street 1:18 WILLIS RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4079
Mailing Address - Country:US
Mailing Address - Phone:302-222-6462
Mailing Address - Fax:
Practice Address - Street 1:GENERAL HEALTHCARE RESOURSES
Practice Address - Street 2:5700 KIRKWOOD HWY SUITE 203
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4079
Practice Address - Country:US
Practice Address - Phone:302-998-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE000031370507376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide