MEDICARE: NIKKI HUNTER GREENAWAY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP1700X	Perinatal Nurse Practitioner	1057444	TX
2	363LW0102X	Women's Health Nurse Practitioner	AP07023	LA
3	363LW0102X	Women's Health Nurse Practitioner	1057444	TX
4	363LP1700X	Perinatal Nurse Practitioner	AP07023	LA

General Provider Information

NPI Number	:	1841541257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKI HUNTER GREENAWAY NP

Provider Business Mailing Address
First Line	:	29207 DALEA CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-6063
Country	:	US
Telephone Number	:	504-535-4913
Fax Number	:

Provider Business Practice Location Address
First Line	:	11222 RICHMOND AVE STE 201
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2696
Country	:	US
Telephone Number	:	504-539-5513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	10/05/2023

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