Provider Demographics
NPI:1578766366
Name:GREENE, DENISE FITZGERALD (RNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:FITZGERALD
Last Name:GREENE
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9897 FONTE RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3541
Mailing Address - Country:US
Mailing Address - Phone:714-220-3970
Mailing Address - Fax:
Practice Address - Street 1:9897 FONTE RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3541
Practice Address - Country:US
Practice Address - Phone:714-220-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456710363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care