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General NPI Number Information
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NPI Number | 1598498453
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Entity Type | Individual
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Provider Name | ALEXANDRA MAE GREGG RD, LD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 2420 SW WINTERFIELD CT
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City | LEES SUMMIT
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State | MO
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Zip | 64081-4098
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Country | US
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Telephone | 816-875-0077
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Fax | 507-322-1832
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Provider Business Mailing Address
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Address Line | 8450 NW PR VW RD # 1441
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City | KANSAS CITY
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State | MO
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Zip | 64153-1841
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Country | US
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Telephone | 507-990-4403
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Fax | 507-322-1832
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2022025851
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License Number State | MO
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