Individual
JANELLE L GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 FAIRVIEW CIR, LEBANON, PA 17042-9581
(717) 279-7303
(717) 279-7471
Mailing address
PO BOX 300, LEBANON, PA 17042-0300
(717) 270-7780
(717) 274-9746
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA002360L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50050092
CAPITAL BLUE CROSS
PA
01
—
P00235193
RAILROAD MEDICARE
PA
Enumeration date
04/03/2006
Last updated
12/15/2014
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