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Individual

JOHNATHAN SETH GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Mailing address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1715680
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
26595
TN

Other

Enumeration date
09/30/2019
Last updated
07/27/2021
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