Gregg, Shawnte Renee

Gregg, Shawnte Renee is an individual health care provider with primary practice located at 4688 W Tangerine Rd Apt 12208 , Marana AZ 85658-4890. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gregg, Shawnte Renee can be contacted via phone (765) 215-7332.

Contact Information

Primary practice address
4688 W Tangerine Rd Apt 12208 Marana AZ 85658-4890
Phone: (765) 215-7332
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002489A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP9774 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71002489A Indiana

Profile Details

NPI number 1629265483
LBN Legal business name Gregg, Shawnte Renee
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2007
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629265483 NPPES
Indiana MEDICAID 200875520

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