1356874028 NPI number — MRS. KAITLYN ELIZABETH LOUISE GREER MD

Table of content: MRS. KAITLYN ELIZABETH LOUISE GREER MD (NPI 1356874028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356874028 NPI number — MRS. KAITLYN ELIZABETH LOUISE GREER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREER
Provider First Name:
KAITLYN
Provider Middle Name:
ELIZABETH LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SNYDER
Provider Other First Name:
KAITLYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356874028
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 TAFT HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIGNAL MOUNTAIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37377-2774
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-778-9434
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 TAFT HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIGNAL MOUNTAIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37377-2774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-778-9434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2017

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 64629 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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