MEDICARE: MRS. CARRIE ANNE GREENWOOD R.N.

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	RN.287014	OH

General Provider Information

NPI Number	:	1619120656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE ANNE GREENWOOD R.N.

Provider Business Mailing Address
First Line	:	119 NORRIS ST
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-1580
Country	:	US
Telephone Number	:	740-526-0302
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 NORRIS ST
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-1580
Country	:	US
Telephone Number	:	740-526-0302
Fax Number	:

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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