Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Mallery Gray Gannaway, AA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1306353685

Mrs. Mallery Gray Gannaway, AA is a Student in an Organized Health Care Education/Training Program in Oklahoma City, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2018
Specialties on file
2

Practice location Address checks out

12301 N Macarthur Blvd Apt 304
Oklahoma City, OK 73142-3039
Phone: (405) 406-7112
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X (OK)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 737 (OK)

Record details

NPI number1306353685
Entity typeIndividual (Type 1)
GenderFemale
Credentials AA
Sole proprietorYes
NPI enumeratedJanuary 8, 2018
Last updated in NPPESJanuary 8, 2018

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