Individual
MR. KENNETH NATHAN GREGORY
Active
Individual
MR. KENNETH NATHAN GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0050-03738
NC
363LF0000X
Family Nurse Practitioner
Primary
00503738
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851570444
—
NC
Enumeration date
10/30/2007
Last updated
01/13/2022
Update your record
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