Provider Demographics
NPI:1316381320
Name:GRECO, KRISTINE LEENA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:LEENA
Last Name:GRECO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:LEENA
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:498 ROUTE 9D
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-4079
Mailing Address - Country:US
Mailing Address - Phone:845-321-0298
Mailing Address - Fax:
Practice Address - Street 1:498 ROUTE 9D
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-4079
Practice Address - Country:US
Practice Address - Phone:845-321-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645299163W00000X
NY346456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse