Provider Demographics
NPI:1982112108
Name:OBERSCHMIDT, GREGORY (RN)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:OBERSCHMIDT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 RIVERFRONT PKWY STE 209
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-3312
Mailing Address - Country:US
Mailing Address - Phone:423-634-5886
Mailing Address - Fax:423-265-8972
Practice Address - Street 1:1301 RIVERFRONT PKWY STE 209
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-3312
Practice Address - Country:US
Practice Address - Phone:423-634-5886
Practice Address - Fax:423-265-8972
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN181468163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health