Provider Demographics
NPI:1104674399
Name:AYERS, GREGORY FORREST (RN)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:FORREST
Last Name:AYERS
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 1:302 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6302
Mailing Address - Country:US
Mailing Address - Phone:803-641-5100
Mailing Address - Fax:
Practice Address - Street 1:UNIT 45011
Practice Address - Street 2:
Practice Address - City:CAMP ZAMA
Practice Address - State:APO, AP
Practice Address - Zip Code:96343
Practice Address - Country:JP
Practice Address - Phone:315-263-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-11
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC243657163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency