Healthcare Provider Details

I. General information

NPI: 1639158363
Provider Name (Legal Business Name): NANCY L GREER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20040 N 19TH AVE STE C
PHOENIX AZ
85027-4256
US

IV. Provider business mailing address

20040 N 19TH AVE STE C
PHOENIX AZ
85027-4256
US

V. Phone/Fax

Practice location:
  • Phone: 623-869-8948
  • Fax:
Mailing address:
  • Phone: 623-869-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number66843
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: