Provider Demographics
NPI:1285801746
Name:GRESSETT, TONI
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:
Last Name:GRESSETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53253
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-3253
Mailing Address - Country:US
Mailing Address - Phone:910-916-4205
Mailing Address - Fax:
Practice Address - Street 1:5329 RAMSEY STREET
Practice Address - Street 2:#19
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1331
Practice Address - Country:US
Practice Address - Phone:910-916-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC30043747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant