Individual
JENNIFER MARIE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1202 HIGHWAY 60 BLDG D, SOCORRO, NM 87801-3914
(575) 838-4689
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3016528
KY
363LF0000X
Family Nurse Practitioner
Primary
65639
NM
Other
Enumeration date
09/11/2021
Last updated
12/07/2021
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