Healthcare Provider Details

I. General information

NPI: 1164363057
Provider Name (Legal Business Name): MARK ANDREW GREINER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 S 91ST ST APT 801
LINCOLN NE
68526-9731
US

IV. Provider business mailing address

7140 S 91ST ST APT 801
LINCOLN NE
68526-9731
US

V. Phone/Fax

Practice location:
  • Phone: 531-218-4987
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: