Provider Demographics
NPI:1689025447
Name:GREGG, JESSICA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GREGG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 N KANSAS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4453
Mailing Address - Country:US
Mailing Address - Phone:402-460-5787
Mailing Address - Fax:402-460-5794
Practice Address - Street 1:715 N KANSAS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4453
Practice Address - Country:US
Practice Address - Phone:402-460-5787
Practice Address - Fax:402-460-5794
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE112037363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care