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General NPI Number Information
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NPI Number | 1720582109
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Entity Type | Individual
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Provider Name | SETH GREENE RN
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Gender | Male
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 2720 MARTIN LUTHER KING JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-2601
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Country | US
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Telephone | 954-309-4927
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W LOCUST ST
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City | OCCOQUAN
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State | VA
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Zip | 22125-7723
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Country | US
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Telephone |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN1048020
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License Number State | DC
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