Healthcare Provider Details

I. General information

NPI: 1750799839
Provider Name (Legal Business Name): HEATHER GREENING CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OXFORD DR SUITE 201
BETHEL PARK PA
15102-1827
US

IV. Provider business mailing address

2386 CRESTVIEW RD
PITTSBURGH PA
15216-2725
US

V. Phone/Fax

Practice location:
  • Phone: 412-854-7570
  • Fax: 412-854-6149
Mailing address:
  • Phone: 412-334-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013924
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN609426
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: