Individual
MRS. STACY LYNN GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
949 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 222-3132
(318) 222-3865
Mailing address
949 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 222-3132
(318) 222-3865
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
291146
LA
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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