Provider Demographics
NPI:1083153001
Name:GREENE, TIANNA KATHRYN POWELL (CNM)
Entity Type:Individual
Prefix:MRS
First Name:TIANNA
Middle Name:KATHRYN POWELL
Last Name:GREENE
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:108 SUNSET OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9467
Mailing Address - Country:US
Mailing Address - Phone:908-420-2038
Mailing Address - Fax:
Practice Address - Street 1:4414 LAKE BOONE TRL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7513
Practice Address - Country:US
Practice Address - Phone:919-351-8253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00060200367A00000X
NC768367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife