Provider Demographics
NPI:1457678054
Name:GREENHILL, JO E (APRN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:JO
Middle Name:E
Last Name:GREENHILL
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:JO ELLEN
Other - Middle Name:
Other - Last Name:GREENHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CPNP
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:870-347-3492
Practice Address - Street 1:1500 MUSEUM RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032
Practice Address - Country:US
Practice Address - Phone:501-932-9010
Practice Address - Fax:501-932-0020
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03167363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR198811758Medicaid