Provider Demographics
NPI:1558352237
Name:GRECO, VIRGINIA ARENT (APNP)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ARENT
Last Name:GRECO
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 N 109TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3754
Mailing Address - Country:US
Mailing Address - Phone:414-777-1811
Mailing Address - Fax:414-777-1812
Practice Address - Street 1:830 N 109TH ST
Practice Address - Street 2:STE 1
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3754
Practice Address - Country:US
Practice Address - Phone:414-777-1811
Practice Address - Fax:414-777-1812
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2192-033363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43974800Medicaid
WI43974800Medicaid
WI000468925Medicare ID - Type Unspecified