Individual
ALICIA MARIE GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6024 WALTON RD, KINGSLEY, MI 49649-9275
(605) 670-1407
Mailing address
6024 WALTON RD, KINGSLEY, MI 49649-9275
(605) 670-1407
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704354778
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704354778
NURSING LICENSE
MI
Enumeration date
08/29/2019
Last updated
08/29/2019
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