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General NPI Number Information
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NPI Number | 1053138909
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Entity Type | Individual
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Provider Name | LYNETTE LEIGH GREATHOUSE RN
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 416 W RIDGE ST
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City | ROSE HILL
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State | NC
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Zip | 28458-7733
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Country | US
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Telephone | 919-222-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 103 BETT DR
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City | GOLDSBORO
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State | NC
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Zip | 27534-9569
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Country | US
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Telephone | 919-222-7717
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5022908
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 263614
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License Number State | NC
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