Individual
ROBERT GREENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1500 PANCHERI DR STE 4, IDAHO FALLS, ID 83402-3212
(208) 579-6087
(888) 519-8898
Mailing address
1500 PANCHERI DR STE 4, IDAHO FALLS, ID 83402-3212
(208) 579-6087
(888) 519-8898
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
58629
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
58629
ID
Other
Enumeration date
01/23/2020
Last updated
09/06/2022
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