Provider Demographics
NPI:1992247662
Name:GREGGAINS, NORA SUTTON (MS)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:SUTTON
Last Name:GREGGAINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:LEE
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 SW 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1925
Mailing Address - Country:US
Mailing Address - Phone:954-452-1924
Mailing Address - Fax:
Practice Address - Street 1:1308 SW 151ST AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1925
Practice Address - Country:US
Practice Address - Phone:954-452-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-13
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL3452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer