Individual
REBECCA N GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
485 S DOBSON RD STE 110, CHANDLER, AZ 85224-5600
(480) 728-4470
(480) 728-4499
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5496
AZ
363AS0400X
Surgical Physician Assistant
Primary
5496
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85241
—
AZ
01
—
Z18222
MEDICARE PTAN
AZ
Enumeration date
09/27/2013
Last updated
11/21/2024
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