Provider Demographics
NPI:1811763261
Name:GREGORY, JASMINE (CPC(PD), RMT)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:CPC(PD), RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 RIVER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-3166
Mailing Address - Country:US
Mailing Address - Phone:217-413-5265
Mailing Address - Fax:
Practice Address - Street 1:6140 RIVER POINTE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-3166
Practice Address - Country:US
Practice Address - Phone:217-413-5265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula