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Individual

MR. KENNETH NATHAN GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
VIDANT EDGECOMBE EMERGENCY DEPARTMENT, 111 HOSPITAL DRIVE, TARBORO, NC 27886-2011
(252) 641-7150
Mailing address
VIDANT EDGECOMBE ED, 111 HOSPITAL DRIVE, TARBORO, NC 27886-2011
(252) 641-7150

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
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