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General NPI Number Information
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NPI Number | 1255173969
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Entity Type | Individual
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Provider Name | KAILA MARIE GREGG PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2024
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 168 JACKSON PEAK DR
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City | KALISPELL
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State | MT
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Zip | 59901-7157
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Country | US
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Telephone | 406-540-9041
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Fax | 406-295-1196
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Provider Business Mailing Address
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Address Line | 20019 W MAZATZAL DR
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City | WITTMANN
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State | AZ
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Zip | 85361-5015
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Country | US
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Telephone | 623-850-6611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3080001
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License Number State | AZ
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