MEDICARE: MS. GRETA STEPHENS RNFA

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	163WR0006X	Registered Nurse First Assistant	649009	TX

General Provider Information

NPI Number	:	1851754360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GRETA STEPHENS RNFA

Provider Business Mailing Address
First Line	:	6729 OLIVER DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8119
Country	:	US
Telephone Number	:	817-988-1067
Fax Number	:	972-986-5304

Provider Business Practice Location Address
First Line	:	6729 OLIVER DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8119
Country	:	US
Telephone Number	:	817-988-1067
Fax Number	:	972-986-5304

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

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

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