Provider Demographics
NPI:1770460487
Name:GREENE, TODD ROBERT
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ROBERT
Last Name:GREENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2540
Mailing Address - Country:US
Mailing Address - Phone:308-641-0518
Mailing Address - Fax:
Practice Address - Street 1:1901 5TH AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2540
Practice Address - Country:US
Practice Address - Phone:308-641-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide