Basic Information
| Provider Information | |||||||||
| NPI: | 1689068231 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREGORY | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | BAILEY | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | AGACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 817 WOODMAR DR | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359065849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565587232 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8000 AL HIGHWAY 69 | ||||||||
| Address2: | |||||||||
| City: | GUNTERSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359767140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565718000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2015 | ||||||||
| LastUpdateDate: | 03/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1-135660 | AL | N | Nursing Service Providers | Registered Nurse | 363LA2100X | 1-135660 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 168906831 | 01 | NPI | OTHER |