Provider Demographics
NPI:1417545575
Name:GRECO, TERESA LEIGH (CRNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LEIGH
Last Name:GRECO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4730
Mailing Address - Country:US
Mailing Address - Phone:717-318-6761
Mailing Address - Fax:
Practice Address - Street 1:14 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LANDISVILLE
Practice Address - State:PA
Practice Address - Zip Code:17538
Practice Address - Country:US
Practice Address - Phone:717-846-6890
Practice Address - Fax:717-219-7409
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023008363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty