Individual
IRENE GREENE-GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
1465 30TH ST STE K, SAN DIEGO, CA 92154-3497
(619) 428-1000
(619) 428-1091
Mailing address
1465 30TH ST STE K, SAN DIEGO, CA 92154-3497
(619) 428-1000
(619) 428-1091
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
758308
CA
363L00000X
Nurse Practitioner
21562
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21562
NP 21562, RN 758308
CA
Enumeration date
06/12/2012
Last updated
06/23/2023
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