MEDICARE: MRS. LINDA WILLIAMS GRENINGER NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	070921	NC
2	363LA2200X	Adult Health Nurse Practitioner	600084	NC
3	363LG0600X	Gerontology Nurse Practitioner	600084	NC
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	600084	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154488203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA WILLIAMS GRENINGER NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	301 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-2083
Country	:	US
Telephone Number	:	336-274-1237
Fax Number	:	336-335-5710

Provider Business Practice Location Address
First Line	:	301 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-2083
Country	:	US
Telephone Number	:	336-274-1237
Fax Number	:	336-335-5710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	06/29/2012

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