Doctor Name: | JANICE GREGORY |
NPI Number: | 1053563106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 1658452 |
Business Practice Address: | 1670 E Hwy 50 Clermont, FL - 347115191 |
Business Phone Number: | 3522435673 |
Business Fax Number: | 3522436599 |
Mailing Address: | 1670 E Hwy 50, CLERMONT |
State: | FL |
Postal Code: | 347115191 |
Phone Number: | 3522435673 |
Fax Number: | 3522436599 |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 10/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1658452 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |