Provider Demographics
NPI:1710061155
Name:GREENFIELD, DONNA (FNP,CNM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:FNP,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 BALTIMORE ANNAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-626-8982
Mailing Address - Fax:410-626-8805
Practice Address - Street 1:1454 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012
Practice Address - Country:US
Practice Address - Phone:410-626-8982
Practice Address - Fax:410-626-8805
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166424363LF0000X, 363L00000X
MDAC001273367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD073199400Medicaid
VAP00397804OtherRAILROAD MEDICARE
VAQ76954Medicare UPIN
VA012844S82Medicare PIN