Healthcare Provider Details

I. General information

NPI: 1720821812
Provider Name (Legal Business Name): DANA ELISE GREGGS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EAST ROLLINS STREET GT 10
ORLANDO FL
32803
US

IV. Provider business mailing address

2248 RIVER PARK CIR APT 633
ORLANDO FL
32817-4890
US

V. Phone/Fax

Practice location:
  • Phone: 407-609-0885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN11030329
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: