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General NPI Number Information
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NPI Number | 1013606011
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Entity Type | Individual
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Provider Name | DONALD ERNEST GREER JR.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 3500 FRANCISCAN WAY
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-0021
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Country | US
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Telephone | 219-879-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 6220 S 775 W
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City | SAN PIERRE
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State | IN
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Zip | 46374-9649
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Country | US
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Telephone | 574-207-3072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28200905A
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License Number State | IN
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