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NPI Code Detail

MEDICARE: JANICE A GREGORY NP

MEDICARE: JANICE A GREGORY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner351WI

General Provider Information

NPI Number : 1184674723
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE A GREGORY NP
Provider Business Mailing Address
First Line : 14675 W HONEY LN
Second Line :
City : NEW BERLIN
State : WI
Zip : 53151-2317
Country : US
Telephone Number : 262-827-0113
Fax Number :
Provider Business Practice Location Address
First Line : 6901 W EDGERTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4420
Country : US
Telephone Number : 414-421-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 09/28/2012

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