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General NPI Number Information
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NPI Number | 1588526032
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Entity Type | Individual
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Provider Name | PATRICIA JANE GREGORY
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 942 MOUNT MORIAH RD STE 105
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City | MEMPHIS
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State | TN
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Zip | 38117-5820
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Country | US
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Telephone | 901-485-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 9930 BARGE DR APT 302
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City | CORDOVA
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State | TN
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Zip | 38016-7117
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Country | US
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Telephone | 901-485-3015
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 097220
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License Number State | TN
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