Provider Demographics
NPI:1093836975
Name:GREEVY, BESS A (APRN, BC, CNM)
Entity Type:Individual
Prefix:
First Name:BESS
Middle Name:A
Last Name:GREEVY
Suffix:
Gender:F
Credentials:APRN, BC, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-0655
Mailing Address - Country:US
Mailing Address - Phone:731-925-2300
Mailing Address - Fax:731-925-3506
Practice Address - Street 1:720 HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-3003
Practice Address - Country:US
Practice Address - Phone:931-722-2229
Practice Address - Fax:931-722-2192
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12582367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
12340OtherBOARD CERTIFICATION
TN3660008Medicaid
TN4233024OtherBCBS TN
TNAPN12582OtherAPN LICENSE
12340OtherBOARD CERTIFICATION