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Individual

KIM MCPHERSON GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, ED.D..

Contact information

Practice address
1254 CONCORD RD SE, SUITE 204, SMYRNA, GA 30080-4371
(678) 842-0604
(186) 628-1862
Mailing address
1254 CONCORD RD SE, SUITE 204, SMYRNA, GA 30080-4371
(678) 842-0604
(186) 628-1862

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN060677
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000844742A
GA
05
000844742B
GA
Enumeration date
05/15/2008
Last updated
05/15/2008
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