Provider Demographics
NPI:1194274712
Name:GREGOROFF, RACHEL M (CRNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:GREGOROFF
Suffix:
Gender:F
Credentials:CRNP
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Other - First Name:
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Mailing Address - Street 1:700 8TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:579 S INDIANA AVE STE A
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3751
Practice Address - Country:US
Practice Address - Phone:941-460-1341
Practice Address - Fax:941-460-1345
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2021-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP016519363LF0000X
FLAPRN11011583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily