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Individual

JAGAIL D GREENLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
28129439A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100240880
IN
Enumeration date
05/22/2008
Last updated
10/09/2015
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