Individual
LISA CAROL GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP-BC
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3111
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71003004A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000796329
ANTHEM
IN
05
—
200954520
—
IN
01
—
P00762166
RAILROAD MEDICARE
IN
Enumeration date
08/20/2009
Last updated
03/25/2026
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