Provider Demographics
NPI:1033548086
Name:GREENE, KATEY (NTP)
Entity Type:Individual
Prefix:
First Name:KATEY
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9637
Mailing Address - Country:US
Mailing Address - Phone:303-489-3027
Mailing Address - Fax:303-526-4072
Practice Address - Street 1:28677 BUFFALO PARK RD STE 204
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7378
Practice Address - Country:US
Practice Address - Phone:303-489-3027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education