Provider Demographics
NPI:1689202426
Name:GREENE, CHRISTINA (APRN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 STARBOARD ST UNIT 310
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6907
Mailing Address - Country:US
Mailing Address - Phone:845-649-8714
Mailing Address - Fax:
Practice Address - Street 1:1000 WOODCOCK RD STE 120
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3509
Practice Address - Country:US
Practice Address - Phone:845-649-8714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL95034444163W00000X
FLAPRN11015304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse