Provider Demographics
NPI:1518797844
Name:GREY, DEVIN (PMHNP)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:GREY
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 CROSSPINE WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7367
Mailing Address - Country:US
Mailing Address - Phone:305-484-1875
Mailing Address - Fax:
Practice Address - Street 1:2750 TAYLOR AVE STE A-89
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4474
Practice Address - Country:US
Practice Address - Phone:407-505-5596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034378363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health