Individual
MISS KIMBERLY ALENE GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(973) 676-1000
Mailing address
60 RAVENSWOOD AVE, PROVIDENCE, RI 02908-2022
(732) 742-3334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00163000
NJ
363AS0400X
Surgical Physician Assistant
Primary
PA00463
RI
Other
Enumeration date
11/20/2006
Last updated
07/22/2011
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