Provider Demographics
NPI:1457507543
Name:GREENE, KATHERINE ROBINSON (RN)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:ROBINSON
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E ALLEN ST
Mailing Address - Street 2:APT. 24
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2213
Mailing Address - Country:US
Mailing Address - Phone:407-416-0486
Mailing Address - Fax:
Practice Address - Street 1:15 E ALLEN ST
Practice Address - Street 2:APT. 24
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2213
Practice Address - Country:US
Practice Address - Phone:407-416-0486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0260039908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse