Individual
MR. JEFFREY STEPHEN GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 MORRIS STREET, CHARLESTON, WV 25301
(304) 388-6220
(304) 388-3604
Mailing address
675 THOROFARE ROAD, CLENDENIN, WV 25045
(304) 388-6220
(304) 388-3604
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26781
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
33938
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065010000
—
WV
Enumeration date
12/04/2006
Last updated
09/11/2025
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