MEDICARE: MRS. DONNA CAROLE GREENE

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	225X00000X	Occupational Therapist	1032	NC

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	:	1780715565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA CAROLE GREENE

Provider Business Mailing Address
First Line	:	8007 GILANO DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-9488
Country	:	US
Telephone Number	:	919-606-1019
Fax Number	:

Provider Business Practice Location Address
First Line	:	8007 GILANO DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-9488
Country	:	US
Telephone Number	:	919-606-1019
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/16/2019

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Directions to “ MRS. DONNA CAROLE GREENE ” Practice Location

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