Provider Demographics
NPI:1154106912
Name:GREGORY, LINCY (DNP, APRN-CNP)
Entity type:Individual
Prefix:DR
First Name:LINCY
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DNP, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 CHICKAMAUGA DR
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-7107
Mailing Address - Country:US
Mailing Address - Phone:304-620-5058
Mailing Address - Fax:
Practice Address - Street 1:1948 WILTSHIRE RD
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-2783
Practice Address - Country:US
Practice Address - Phone:304-728-8416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV117458363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health