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

Susan Wambui Gray

Individual provider Licensed Practical Nurse · NPI 1306070701

Susan Wambui Gray is a Nurse Practitioner in Orlando, Florida. Qualified in 2019, 7 years ago. Practices with Lifestream Behavioral Center Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
7
Licensed in
FL, GA
In the registry since
2009
Specialties on file
2
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Practice location Address checks out

14055 Budworth Cir
Orlando, FL 32832-6123
Phone: (770) 912-8905
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 11016895 (FL)
Licensed Practical Nurse Taxonomy 164W00000X · Licence LPN074267 (GA)

Record details

NPI number1306070701
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 13, 2009
Last updated in NPPESDecember 20, 2021
Certification dateDecember 20, 2021
Mailing address14055 Budworth Cir, Orlando, FL 32832-6123

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Lifestream Behavioral Center Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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