Individual
KIERSTEN L. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
975 RYLAND ST STE 100, RENO, NV 89502-1669
(775) 982-5000
(775) 982-5225
Mailing address
1155 MILL ST # M14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1126
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-0431018
TRI CARE
CA
05
—
GR0093170
—
CA
01
—
ZZZ04918Z
BLUE SHIELD
CA
Enumeration date
09/29/2006
Last updated
02/27/2025
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