MEDICARE: KATHRYN JEAN GREGORY LVN, CST, CFA, LSA

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
1	164X00000X	Licensed Vocational Nurse	042647	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CD6262	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5624377	OTHER	TX	CIGNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255429569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN JEAN GREGORY LVN, CST, CFA, LSA

Provider Business Mailing Address
First Line	:	8801 MARTI LN
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-3257
Country	:	US
Telephone Number	:	817-905-7352
Fax Number	:	817-812-2900

Provider Business Practice Location Address
First Line	:	8801 MARTI LN
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-3257
Country	:	US
Telephone Number	:	817-905-7352
Fax Number	:	817-812-2900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	09/11/2008

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