Healthcare Provider Details

I. General information

NPI: 1063212223
Provider Name (Legal Business Name): HILLIARY KATE GREENE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 N DECATUR RD NE APT B
ATLANTA GA
30306-2301
US

IV. Provider business mailing address

1202 N DECATUR RD NE APT B
ATLANTA GA
30306-2301
US

V. Phone/Fax

Practice location:
  • Phone: 478-972-7408
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN181991
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: