Provider Demographics
NPI:1427016716
Name:GREINER, ANDREA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:GREINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:FICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPT OF OBGYN
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-3180
Mailing Address - Fax:319-353-6759
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPT OF OBGYN
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-3180
Practice Address - Fax:319-353-6759
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115757207V00000X, 207VM0101X
IA36857207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207239609Medicaid
P00859523OtherRAILROAD MEDICARE
431560263OtherTRICARE WEST
IA0731273Medicaid
IA0731273Medicaid
MO207239609Medicaid
IAI18414Medicare PIN
431560263OtherTRICARE WEST