Individual
JEANA M GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
Mailing address
542 REDWOOD DR, MOORESVILLE, IN 46158-7614
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
10003212A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300050204
—
IN
Enumeration date
10/18/2016
Last updated
05/16/2025
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