Michael E Gregg
Licensed Practical Nurse in Roseburg, OR. Individual provider (NPI-1).
NPI number1164021283
StatusActive
Last updated in NPPESOct 20, 2020
Details
- NPI
- 1164021283
- Entity type
- Individual (NPI-1)
- Name
- Michael E Gregg
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 20, 2020
- Certification date
- Oct 20, 2020
- Last updated
- Oct 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 201508156LPN | OR | Yes |
Practice location
3099 Ne Diamond Lake BlvdRoseburg, OR 97470-3655
Phone 541-673-3469
Mailing address
621 W Madrone StRoseburg, OR 97470-3090
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