Healthcare Provider Details

I. General information

NPI: 1588526032
Provider Name (Legal Business Name): PATRICIA JANE GREGORY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 MOUNT MORIAH RD STE 105
MEMPHIS TN
38117-5820
US

IV. Provider business mailing address

9930 BARGE DR APT 302
CORDOVA TN
38016-7117
US

V. Phone/Fax

Practice location:
  • Phone: 901-485-3015
  • Fax:
Mailing address:
  • Phone: 901-485-3015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number097220
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: