Provider Demographics
NPI:1750320818
Name:GREER, MARY ELAINE (RNNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELAINE
Last Name:GREER
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2457
Mailing Address - Country:US
Mailing Address - Phone:816-671-1331
Mailing Address - Fax:816-676-1311
Practice Address - Street 1:1331 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2457
Practice Address - Country:US
Practice Address - Phone:816-671-1331
Practice Address - Fax:816-676-1311
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO045272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO30625038OtherBLUE CROSS OF KANSAS CITY
P00235151OtherRAILROAD MEDICARE
P00235151OtherRAILROAD MEDICARE
P23384Medicare UPIN