Provider Demographics
NPI:1497327902
Name:CREEHAN, GREER MICHELLE
Entity Type:Individual
Prefix:
First Name:GREER
Middle Name:MICHELLE
Last Name:CREEHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14433 BLUE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32409-4666
Mailing Address - Country:US
Mailing Address - Phone:850-738-3085
Mailing Address - Fax:
Practice Address - Street 1:14433 BLUE LAKE RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32409-4666
Practice Address - Country:US
Practice Address - Phone:850-640-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3291332163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health