Individual
ELIZABETH B GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
1690 SKYLYN DR STE 300A, SPARTANBURG, SC 29307-1022
(864) 424-0003
(864) 585-2488
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
19576
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP8279
—
SC
01
—
SC68855019
MEDICARE PIN
SC
Enumeration date
06/25/2015
Last updated
02/21/2023
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