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NPI Code Detail

MEDICARE: MS. OLYMPIA DENISE GREGORY CNM

MEDICARE: MS. OLYMPIA DENISE GREGORY CNM
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
1367A00000XAdvanced Practice Midwife000025CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1400000025CT04OTHERCTBLUE CROSS BLUE SHIELD
29468073OTHERCTPHCS
3P3755989OTHERCTOXFORD
42731919OTHERCTUNITED HEALTHCARE
56431476OTHERCTCIGNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
77774815OTHERCTAETNA
82V5102OTHERCTHEALTHNET

General Provider Information

NPI Number : 1477653475
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. OLYMPIA DENISE GREGORY CNM
Provider Business Mailing Address
First Line : 108 NEW LONDON TPKE
Second Line :
City : NORWICH
State : CT
Zip : 06360-2645
Country : US
Telephone Number : 860-859-3612
Fax Number : 860-859-3343
Provider Business Practice Location Address
First Line : 108 NEW LONDON TPKE
Second Line :
City : NORWICH
State : CT
Zip : 06360-2645
Country : US
Telephone Number : 860-859-3612
Fax Number : 860-859-3343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 03/20/2019

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