Provider Demographics
NPI:1508057910
Name:GREENE, BELINDA MASON (LPN)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:MASON
Last Name:GREENE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S MANGUM ST
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3904
Mailing Address - Country:US
Mailing Address - Phone:919-683-1790
Mailing Address - Fax:
Practice Address - Street 1:705 S MANGUM ST
Practice Address - Street 2:BUILDING 3
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3904
Practice Address - Country:US
Practice Address - Phone:919-683-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC032742164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse