Individual
MRS. SHARON HOPE GREACEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT(ASCP)
Contact information
Practice address
12000 STONE LAKE DRIVE, LABORATORY, DULCE, NM 87528-0187
(505) 759-7218
Mailing address
PO BOX 997, DULCE, NM 87528-0997
(970) 749-4633
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
07/24/2006
Last updated
04/17/2008
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