Individual
MRS. THERESA SHARLENE GOSS GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1826 VETERANS BLVD, DUBLIN, GA 31021-3620
(478) 272-1210
(478) 277-2823
Mailing address
1826 VETERANS BLVD, DUBLIN, GA 31021-3620
(478) 272-1210
(478) 277-2823
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
130065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130065
STATE BOARD OF NURSING
GA
Enumeration date
04/09/2008
Last updated
04/09/2008
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