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Individual
MATTHEW S GREENE
Active
Individual
MATTHEW S GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP132253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
369843301
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
8073MB
BCBS
TX
01
—
P01787482
RAIL ROAD MEDICARE
TX
Enumeration date
11/30/2016
Last updated
06/09/2017
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