Individual
STACEY M GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 N ROSE ST, PHOENIX, OR 97535-5734
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201501988RN
OR
Other
Enumeration date
08/25/2023
Last updated
02/16/2024
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