Provider Demographics
NPI:1891012894
Name:GREGORY, JAMES STEVEN (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:GREGORY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0323
Mailing Address - Country:US
Mailing Address - Phone:530-528-9032
Mailing Address - Fax:530-528-9032
Practice Address - Street 1:2550 SISTER MARY COLUMBA DR
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4327
Practice Address - Country:US
Practice Address - Phone:530-528-9032
Practice Address - Fax:530-528-9032
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLANT 3186892367500000X
WAAP61004444367500000X
CANA95000173367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered