Provider Demographics
NPI:1558847491
Name:GREGORY, VALERIE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:GREGORY
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 1:3825 ROLAND BLVD, STE. 2N
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2931
Mailing Address - Country:US
Mailing Address - Phone:314-337-7636
Mailing Address - Fax:314-833-3095
Practice Address - Street 1:3825 ROLAND BLVD, STE. 2N
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-2931
Practice Address - Country:US
Practice Address - Phone:314-337-7636
Practice Address - Fax:314-833-3095
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018021382163WH0200X, 163WP0807X, 163WW0101X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory