Healthcare Provider Details

I. General information

NPI: 1184490302
Provider Name (Legal Business Name): HOPE LADAWN GREENWADE MSN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 ELIZABETH ST STE 804
CORPUS CHRISTI TX
78404-2231
US

IV. Provider business mailing address

325 S ELM DR
PAYSON AZ
85541-4576
US

V. Phone/Fax

Practice location:
  • Phone: 361-854-0811
  • Fax: 361-806-5040
Mailing address:
  • Phone: 480-244-6439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number300639
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1191863
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: