Provider Demographics
NPI:1437227154
Name:GREINER, PAMLA SANDRA (RN, CNP)
Entity Type:Individual
Prefix:
First Name:PAMLA
Middle Name:SANDRA
Last Name:GREINER
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 TROTT AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2743
Mailing Address - Country:US
Mailing Address - Phone:218-685-4036
Mailing Address - Fax:
Practice Address - Street 1:26371 210TH AVE
Practice Address - Street 2:
Practice Address - City:ELBOW LAKE
Practice Address - State:MN
Practice Address - Zip Code:56531-9285
Practice Address - Country:US
Practice Address - Phone:218-685-4036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR053695-6363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health