Provider Demographics
NPI:1578744132
Name:GREER, LATRISHA (RN)
Entity Type:Individual
Prefix:
First Name:LATRISHA
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BUCHANAN AVE
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-2503
Mailing Address - Country:US
Mailing Address - Phone:631-374-3762
Mailing Address - Fax:
Practice Address - Street 1:9 BUCHANAN AVE
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-2503
Practice Address - Country:US
Practice Address - Phone:631-374-3762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY537183-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse