Provider Demographics
NPI:1033469499
Name:GREENE, LORA DAWN (R N)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:DAWN
Last Name:GREENE
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:DAWN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:R N
Mailing Address - Street 1:118 PALM COTTAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443
Mailing Address - Country:US
Mailing Address - Phone:910-233-0971
Mailing Address - Fax:
Practice Address - Street 1:118 PALM COTTAGE DRIVE
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443
Practice Address - Country:US
Practice Address - Phone:910-233-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228533163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health