Provider Demographics
NPI:1457469298
Name:GREGORY, MARIBEL N (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:N
Last Name:GREGORY
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 COYLE AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6333
Mailing Address - Country:US
Mailing Address - Phone:916-536-9455
Mailing Address - Fax:916-536-9424
Practice Address - Street 1:6620 COYLE AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6333
Practice Address - Country:US
Practice Address - Phone:916-536-9455
Practice Address - Fax:916-536-9424
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562994163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical