MEDICARE: GREEG FAMILY HEALTHCARE SERVICES

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	363LF0000X	Family Nurse Practitioner

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	:	1275660219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEG FAMILY HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	1557 MONTE VISTA AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5731
Country	:	US
Telephone Number	:	575-532-5700
Fax Number	:	575-532-5733

Provider Business Practice Location Address
First Line	:	1557 MONTE VISTA AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5731
Country	:	US
Telephone Number	:	575-532-5700
Fax Number	:	575-532-5733

Authorized Official
Title or Position	:	OFFICE MANAGER/CMC
Name	:	MELISSA ROMAN
Credential	:
Telephone Number	:	575-532-5700

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/06/2010

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Directions to “GREEG FAMILY HEALTHCARE SERVICES ” Practice Location

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