Provider Demographics
NPI:1104216241
Name:GREENFIELD, KERI KELLY (APRN)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:KELLY
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:KERI
Other - Middle Name:KELLY
Other - Last Name:GREENFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3848 FAU BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6437
Mailing Address - Country:US
Mailing Address - Phone:561-455-3627
Mailing Address - Fax:561-393-7312
Practice Address - Street 1:3848 FAU BLVD STE 305
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:561-455-3627
Practice Address - Fax:561-393-7312
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9267805363LA2200X
FLAPRN9267805363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health