Individual
ALETA B GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
932 E 34TH STREET, JOPLIN, MO 64804
(417) 347-8310
(417) 347-8314
Mailing address
PO BOX 3810, JOPLIN, MO 64803
(417) 347-8310
(417) 347-8314
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
119577
MO
207RN0300X
Nephrology Physician
TW00066
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100346130E
—
KS
01
—
121157
ANTHEM
—
05
—
200045630A
—
OK
05
—
204693410
—
MO
01
—
P00175279
RR MEDICARE
—
Enumeration date
06/24/2006
Last updated
07/14/2022
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