Provider Demographics
NPI:1912220054
Name:ELSHIEKH CREGO, NINA (PHD, LMBT)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:ELSHIEKH CREGO
Suffix:
Gender:F
Credentials:PHD, LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7710
Mailing Address - Country:US
Mailing Address - Phone:919-219-3517
Mailing Address - Fax:
Practice Address - Street 1:2206 PAGE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7710
Practice Address - Country:US
Practice Address - Phone:919-219-3517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1474225700000X, 226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist