Provider Demographics
NPI:1437382983
Name:GREGORY, DIANN SHIRLEY (ARNP, CNM)
Entity Type:Individual
Prefix:MRS
First Name:DIANN
Middle Name:SHIRLEY
Last Name:GREGORY
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13130 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-4732
Mailing Address - Country:US
Mailing Address - Phone:786-282-7286
Mailing Address - Fax:
Practice Address - Street 1:2015 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4901
Practice Address - Country:US
Practice Address - Phone:305-572-2026
Practice Address - Fax:305-572-2026
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP871062367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife