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NPI Code Detail

MEDICARE: RITA GREENE FNP-C

MEDICARE: RITA GREENE FNP-C
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
1363LF0000XFamily Nurse PractitionerAP 60502642WA
2363LP2300XPrimary Care Nurse Practitioner240170AZ

Other Identifiers

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

General Provider Information

NPI Number : 1235517244
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA GREENE FNP-C
Provider Business Mailing Address
First Line : PO BOX 10097
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85130-0020
Country : US
Telephone Number : 520-836-3446
Fax Number :
Provider Business Practice Location Address
First Line : 44572 W BOWLIN RD
Second Line :
City : MARICOPA
State : AZ
Zip : 85138-4558
Country : US
Telephone Number : 520-568-2245
Fax Number : 520-568-2316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2015
Last Update Date : 10/05/2021

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Directions to “ RITA GREENE FNP-C” Practice Location

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