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NPI Code Detail

MEDICARE: LAURI GREIS CNP

MEDICARE: LAURI GREIS CNP
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
1363L00000XNurse PractitionerR37219NM

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 : 1356334999
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURI GREIS CNP
Provider Business Mailing Address
First Line : 255 HWY 187
Second Line : PO BOX 370
City : HATCH
State : NM
Zip : 87937-0370
Country : US
Telephone Number : 505-267-3088
Fax Number : 505-267-1747
Provider Business Practice Location Address
First Line : 1600 THORPE RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-9776
Country : US
Telephone Number : 505-267-3088
Fax Number : 505-267-1747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 07/08/2007

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Directions to “ LAURI GREIS CNP” Practice Location

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