Individual
JOANNIE W GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(866) 507-5244
(855) 851-4405
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN160619
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511I430286
MEDICARE PTAN GA
GA
Enumeration date
01/02/2008
Last updated
11/17/2014
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