Provider Demographics
NPI:1891012894
Name:GREGORY, JAMES STEVEN (CRNA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:GREGORY
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1110
Mailing Address - Country:US
Mailing Address - Phone:407-514-3668
Mailing Address - Fax:321-843-2196
Practice Address - Street 1:52 UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:407-514-3668
Practice Address - Fax:321-843-2196
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61004444367500000X
CANA95000173367500000X
FLANT 3186892367500000X
FLAPRN3186892367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered