Provider Demographics
NPI:1083989933
Name:GREGG, KAREN SUE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:GREGG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 HIGHWAY 81 S
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-7138
Mailing Address - Country:US
Mailing Address - Phone:423-483-1221
Mailing Address - Fax:
Practice Address - Street 1:3920 HIGHWAY 81 S
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-7138
Practice Address - Country:US
Practice Address - Phone:423-483-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55458163WD1100X, 163WG0000X, 163WH0500X, 163WN0300X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WW0000XNursing Service ProvidersRegistered NurseWound Care