| Mrs Mary Helen Gray, RN, NP | |
|
5775 Wayzaya Blvd, Suite 190, St. Louis Park, MN 55416 | |
| (952) 738-4623 | |
| Not Available |
| Full Name | Mrs Mary Helen Gray |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Adult Health |
| Location | 5775 Wayzaya Blvd, St. Louis Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487692448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R 149240 0 (Minnesota) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 2006005436 (Minnesota) | Primary |
| Entity Name | Villagehealth Dm Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598273211 PECOS PAC ID: 2769812445 Enrollment ID: O20210421002585 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Mary Helen Gray, RN, NP 5775 Wayzata Blvd Ste 190, St Louis Park, MN 55416-2627 Ph: (952) 738-4623 | Mrs Mary Helen Gray, RN, NP 5775 Wayzaya Blvd, Suite 190, St. Louis Park, MN 55416 Ph: (952) 738-4623 |
Mr. Charles Iokepa Williams, NP-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1660 Hwy 100 South, Suite 145, St. Louis Park, MN 55416 Phone: 952-456-6160 Fax: 952-456-6184 | |
Renee B Compo, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Gamble Dr Suite 100, Mail Stop 31200a Health Partners West Clinic, St. Louis Park, MN 55416 Phone: 952-541-2500 Fax: 952-595-6455 |