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NPI Code Detail

MEDICARE: MS. SUSAN LEE GREENE CNM MSN

MEDICARE: MS. SUSAN LEE GREENE CNM MSN
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
1367A00000XAdvanced Practice MidwifeNM03522OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1341300581053OTHEROHCARESOURCE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3740493OTHEROHBUCKEYE

General Provider Information

NPI Number : 1740248269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN LEE GREENE CNM MSN
Provider Business Mailing Address
First Line : 3569 RIDGE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-5443
Country : US
Telephone Number : 216-281-0872
Fax Number : 216-281-9565
Provider Business Practice Location Address
First Line : 3569 RIDGE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-5443
Country : US
Telephone Number : 216-281-0872
Fax Number : 216-281-9565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 12/21/2011

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