Provider Demographics
NPI:1508920323
Name:GILL, GRETA LOUISE (CNM)
Entity Type:Individual
Prefix:MS
First Name:GRETA
Middle Name:LOUISE
Last Name:GILL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:GRETA
Other - Middle Name:LOUISE
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-792-9890
Mailing Address - Fax:520-884-9287
Practice Address - Street 1:839 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2819
Practice Address - Country:US
Practice Address - Phone:520-670-3870
Practice Address - Fax:520-670-3896
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574742163WP1700X
AZRN105341367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WP1700XNursing Service ProvidersRegistered NursePerinatal