Individual
MRS. JODIE BROCK GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
152 E KINDERTON WAY, BERMUDA RUN, NC 27006-7350
(336) 893-3210
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 893-3210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
297261
NC
363L00000X
Nurse Practitioner
Primary
5015404
NC
Other
Enumeration date
10/07/2021
Last updated
01/14/2022
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