Provider Demographics
NPI:1962756288
Name:STEELE, GREGORY MARC (FNP)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:MARC
Last Name:STEELE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1975
Mailing Address - Country:US
Mailing Address - Phone:229-312-0344
Mailing Address - Fax:229-312-0345
Practice Address - Street 1:427 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1975
Practice Address - Country:US
Practice Address - Phone:229-312-0344
Practice Address - Fax:229-312-0345
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily