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General NPI Number Information
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NPI Number | 1821846882
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Entity Type | Individual
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Provider Name | LISA MARIE GREGORY CNM, APRN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2024
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 324 E 35TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-4580
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Country | US
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Telephone | 612-827-7181
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Fax |
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Provider Business Mailing Address
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Address Line | 7830 36TH ST N APT 1311
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City | OAKDALE
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State | MN
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Zip | 55128-5780
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Country | US
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Telephone | 651-285-6856
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 579
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License Number State | MN
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