Provider Demographics
NPI:1164823092
Name:GREGERSEN, JAMEY L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMEY
Middle Name:L
Last Name:GREGERSEN
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:720 KENYON RD
Mailing Address - Street 2:NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5759
Mailing Address - Country:US
Mailing Address - Phone:515-955-7171
Mailing Address - Fax:515-573-7898
Practice Address - Street 1:720 KENYON RD
Practice Address - Street 2:NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5759
Practice Address - Country:US
Practice Address - Phone:515-955-7171
Practice Address - Fax:515-573-7898
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2015-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAG109638363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0159608Medicaid