Organization Name: | DEBORAH S GREENE APRN LLC |
NPI Number: | 1336556513 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH SKINNER GREENE (OWNER) |
Mailing Address: | 760 Hopmeadow St Box 813 Simsbury |
State: | CT US |
Postal Code: | 060702223 |
Phone Number: | 8608048684 |
Fax Number: | |
NPI Enumeration Date: | 07/19/2014 |
NPI Last Update Date: | 07/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0809X |
License Number: | 000837 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |