Healthcare Provider Details

I. General information

NPI: 1730980707
Provider Name (Legal Business Name): GRETA MORRISSETTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 BENNING RD NE
WASHINGTON DC
20019-4555
US

IV. Provider business mailing address

1718 9TH ST NW APT 1
WASHINGTON DC
20001-4191
US

V. Phone/Fax

Practice location:
  • Phone: 202-469-4699
  • Fax: 202-548-8600
Mailing address:
  • Phone: 207-632-1142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP500020961
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: