Individual
JARED GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
205 MARENGO ST, FLORENCE, AL 35630-6033
(256) 768-9191
(256) 768-9775
Mailing address
PO BOX 10005, FLORENCE, AL 35631-2005
(256) 768-9191
(256) 768-9775
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-167508
AL
367500000X
Certified Registered Nurse Anesthetist
4704294701
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704294701
MICHIGAN LICENSE
MI
Enumeration date
01/10/2013
Last updated
04/17/2018
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