1942447941 NPI number — TONJA H. M. GREENE CNM

Table of content: TONJA H. M. GREENE CNM (NPI 1942447941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942447941 NPI number — TONJA H. M. GREENE CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENE
Provider First Name:
TONJA
Provider Middle Name:
H. M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942447941
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1575 HIGHLANDS DR
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
LITITZ
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17543-7507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-393-1338
Provider Business Mailing Address Fax Number:
717-627-1817

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1575 HIGHLANDS DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LITITZ
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17543-7507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-393-1338
Provider Business Practice Location Address Fax Number:
717-627-1817
Provider Enumeration Date:
01/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  RN558963 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN558963 . This is a "REGISTERED NURSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102248310 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: MW010193 . This is a "CERTIFIED NURSE MIDWIFE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942447941 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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