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General NPI Number Information
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NPI Number | 1215896097
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Entity Type | Organization
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Legal Business Name | GREENE HOUSE PRIMARY CARE
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 1266 SILVERCREST COURT
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City | POWDER SPRINGS
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State | GA
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Zip | 30127
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Country | US
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Telephone | 470-658-8703
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 BROWNSVILLE RD STE 105
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-8902
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Country | US
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Telephone | 470-658-8703
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Fax |
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Authorized Official
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Title or Position | OWNER / NURSE PRACTITIONER
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Name | MRS. STEPHANIE NICOLE GREENE
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Credential | MSN, FNP-C
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Telephone | 470-658-8703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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