Provider Demographics
NPI:1952543787
Name:GREGG, LINDA JEAN (BSN, RNC, WHNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:GREGG
Suffix:
Gender:F
Credentials:BSN, RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 E PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8990
Mailing Address - Country:US
Mailing Address - Phone:989-773-5921
Mailing Address - Fax:989-426-6952
Practice Address - Street 1:2012 E PRESTON ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-8990
Practice Address - Country:US
Practice Address - Phone:989-773-5921
Practice Address - Fax:989-426-6952
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704101956363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health