Individual
TABITHA PATRICE GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
878 FOX DR, WINCHESTER, VA 22603-8613
(540) 546-2624
Mailing address
878 FOX DR, WINCHESTER, VA 22603-8613
(540) 546-2624
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024188970
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821851247
—
VA
Enumeration date
01/31/2024
Last updated
05/30/2024
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