Individual
MR. GREGORY JAMES GAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNS-BC
Contact information
Practice address
10706 E US HIGHWAY 36, AVON, IN 46123-7982
(317) 271-3600
(317) 271-3604
Mailing address
10706 E US HIGHWAY 36, AVON, IN 46123-7982
(317) 271-3600
(317) 271-3604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
70000205A
IN
364SA2200X
Adult Health Clinical Nurse Specialist
70000205 B- CSR
IN
364SA2200X
Adult Health Clinical Nurse Specialist
70000205A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
# 8516128094
CERTIFIED MEDICAL EXAMINER FOR THE FMCSA
IN
01
—
11832397
CAQH #
IN
01
—
1326218959
NATIONAL PROVIDER INFORMATION
IN
01
—
2006010571
AMERICAN NURSES CREDENTIALING CENTER
IN
01
—
28132624A
REGISTERED NURSE LICENSURE
IN
01
—
70000205A
ADVANCED PRACTICE LICENSURE
IN
01
—
70000205B
CONTROLLED SUBSTANCE REGISTRATION
IN
05
—
LPI # 201262530
—
IN
Enumeration date
03/11/2008
Last updated
03/07/2023
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