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General NPI Number Information
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NPI Number | 1285401133
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Entity Type | Individual
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Provider Name | MISS ELIZABETH LENE GREENE
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Gender | Female
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5862 HARTLE DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-2133
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Country | US
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Telephone | 317-760-7908
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Fax |
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Provider Business Mailing Address
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Address Line | 7009 E 56TH ST STE EE1
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-1371
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Country | US
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Telephone | 317-760-7908
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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