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

MS. Mallory Maryruth Gray, CPNP-PC

Individual provider Pediatric Nurse Practitioner · NPI 1659992899

MS. Mallory Maryruth Gray, CPNP-PC is a Pediatric Nurse Practitioner in Decatur, Georgia. Licensed in Georgia. Registered with an NPI since 2020.

Licensed in
GA
In the registry since
2020

Practice location Address checks out

350 Winn Way
Decatur, GA 30030-2106
Phone: (404) 508-1177
Show map & directions

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

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence RN262243 (GA)

Record details

NPI number1659992899
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP-PC
Sole proprietorNo
NPI enumeratedApril 28, 2020
Last updated in NPPESApril 28, 2020
Certification dateApril 28, 2020

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