Provider Demographics
NPI:1477591626
Name:GREENE, ELIZABETH CARTER (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CARTER
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8894
Mailing Address - Country:US
Mailing Address - Phone:803-419-0973
Mailing Address - Fax:
Practice Address - Street 1:1751 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2606
Practice Address - Country:US
Practice Address - Phone:803-898-0792
Practice Address - Fax:803-898-0897
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC202364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health