Provider Demographics
NPI:1831496348
Name:GREIKA, SHANNON
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:GREIKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 AUTUMN RUN
Mailing Address - Street 2:
Mailing Address - City:BARGERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46106-8369
Mailing Address - Country:US
Mailing Address - Phone:317-534-7835
Mailing Address - Fax:
Practice Address - Street 1:3142 AUTUMN RUN
Practice Address - Street 2:
Practice Address - City:BARGERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46106-8369
Practice Address - Country:US
Practice Address - Phone:317-534-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula