Provider Demographics
NPI:1881159754
Name:GREGG, SARAH CHRISTINE (NP-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CHRISTINE
Last Name:GREGG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 12TH ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2879
Mailing Address - Country:US
Mailing Address - Phone:541-963-0627
Mailing Address - Fax:541-963-2809
Practice Address - Street 1:202 12TH ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2879
Practice Address - Country:US
Practice Address - Phone:541-963-0627
Practice Address - Fax:541-963-2809
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201900772NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily