Provider Demographics
NPI:1003155490
Name:GREGORY, FAITH ANN (LPN)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ANN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 3RD ST
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-1978
Mailing Address - Country:US
Mailing Address - Phone:513-338-3977
Mailing Address - Fax:
Practice Address - Street 1:803 3RD ST
Practice Address - Street 2:APARTMENT A
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-1978
Practice Address - Country:US
Practice Address - Phone:513-338-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH147628164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse