| Doctor Name: | CYNTHIA MIDDLETON GRAY |
| NPI Number: | 1104140987 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 03706 |
| Business Practice Address: | 307 Chisum St Sicily Island, LA - 713684807 |
| Business Phone Number: | 3183895727 |
| Business Fax Number: | 3183894028 |
| Mailing Address: | Po Box 8, 307 Chisum Street SICILY ISLAND |
| State: | LA |
| Postal Code: | 713680008 |
| Phone Number: | 3183895727 |
| Fax Number: | 3183894028 |
| NPI Enumeration Date: | 03/11/2010 |
| NPI Last Update Date: | 06/13/2011 |
| Replacement NPI: | 1104140987 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 03706 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |