Healthcare Provider Details

I. General information

NPI: 1225537103
Provider Name (Legal Business Name): CHRISTINA MARIE GREGORY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5122 GLENCROSSING WAY
CINCINNATI OH
45238-3361
US

IV. Provider business mailing address

1440 W KEMPER RD APT 1808
CINCINNATI OH
45240-4111
US

V. Phone/Fax

Practice location:
  • Phone: 513-827-9044
  • Fax:
Mailing address:
  • Phone: 513-617-6811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN312037
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: