Provider Demographics
NPI:1225463193
Name:GREGSON, SHALYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHALYN
Middle Name:
Last Name:GREGSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SHALYN
Other - Middle Name:
Other - Last Name:QUIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5720 N STONEMILL CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-3120
Mailing Address - Country:US
Mailing Address - Phone:585-802-9339
Mailing Address - Fax:
Practice Address - Street 1:4401 CAMPUS RIDGE DR STE C1100
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6112
Practice Address - Country:US
Practice Address - Phone:989-837-9457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448181183500000X
MI5302044586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist