Healthcare Provider Details

I. General information

NPI: 1033024021
Provider Name (Legal Business Name): NICOL TERESA GREENE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 CARLISLE ST FL 2
GETTYSBURG PA
17325-1809
US

IV. Provider business mailing address

125 N WASHINGTON ST
GETTYSBURG PA
17325-1407
US

V. Phone/Fax

Practice location:
  • Phone: 717-398-5848
  • Fax:
Mailing address:
  • Phone: 717-398-5848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG009365
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: