Healthcare Provider Details

I. General information

NPI: 1629933718
Provider Name (Legal Business Name): PATRICIA ANN GREGORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD BLDG 6B-204
MURFREESBORO TN
37129-1392
US

IV. Provider business mailing address

3400 LEBANON RD BLDG 6B-204
MURFREESBORO TN
37129-1392
US

V. Phone/Fax

Practice location:
  • Phone: 615-225-6417
  • Fax:
Mailing address:
  • Phone: 615-225-6417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number186869
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: