Individual
MS. MARY JANE GREENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
250 E LIBERTY ST, SUITE 202, LOUISVILLE, KY 40202-1530
(502) 585-2300
(502) 584-2726
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 585-2300
(502) 584-2726
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003885
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506700A/B
—
IN
01
—
50040684
PASSPORT-JPG
KY
05
—
78014446
—
KY
Enumeration date
12/07/2005
Last updated
05/12/2014
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