Individual
JONNIE LISA GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1025 VERDAE BLVD, STE A, GREENVILLE, SC 29607-4032
(864) 240-5009
(864) 240-5028
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
679
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0077
—
SC
Enumeration date
01/10/2006
Last updated
02/28/2014
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