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NPI Code Detail

MEDICARE: MRS. CAROLYN KAY GREENING CNS

MEDICARE: MRS. CAROLYN KAY GREENING CNS
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
1364SP0807XChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist071592MO
2364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist071592MO

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 : 1508885187
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN KAY GREENING CNS
Provider Business Mailing Address
First Line : 900 E LAHARPE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-4520
Country : US
Telephone Number : 660-665-1962
Fax Number : 660-665-3989
Provider Business Practice Location Address
First Line : 141 COMMUNICATION DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-3670
Country : US
Telephone Number : 573-795-7342
Fax Number : 573-248-3080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 03/06/2014

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