MEDICARE: MRS. CYNTHIA ANN GREENLEE RN, CNP

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	363LF0000X	Family Nurse Practitioner	NP00843	OH

General Provider Information

NPI Number	:	1982687083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA ANN GREENLEE RN, CNP

Provider Business Mailing Address
First Line	:	6615 JEFF LN
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-8885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 GROSVENOR HALL DR
Second Line	:	OHIO UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
City	:	ATHENS
State	:	OH
Zip	:	45701-2979
Country	:	US
Telephone Number	:	740-593-2500
Fax Number	:

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	11/23/2007

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