Provider Demographics
NPI:1578914529
Name:GREGOIRE, URLINE
Entity Type:Individual
Prefix:
First Name:URLINE
Middle Name:
Last Name:GREGOIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 STURDY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3152
Mailing Address - Country:US
Mailing Address - Phone:508-236-8510
Mailing Address - Fax:508-226-0075
Practice Address - Street 1:19 STURDY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3152
Practice Address - Country:US
Practice Address - Phone:508-236-8510
Practice Address - Fax:508-226-0075
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258009363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner