Provider Demographics
NPI:1639158363
Name:GREER, NANCY L (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:GREER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W 144TH AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023
Mailing Address - Country:US
Mailing Address - Phone:303-469-5843
Mailing Address - Fax:
Practice Address - Street 1:3301 W 144TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023
Practice Address - Country:US
Practice Address - Phone:303-438-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35049208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01350495Medicaid
CO01350495Medicaid