Provider Demographics
NPI:1851867139
Name:GREENWOOD, EMILEE BURTON (APRN)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:BURTON
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:KATHRYN
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1215 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-2900
Mailing Address - Country:US
Mailing Address - Phone:606-753-0293
Mailing Address - Fax:606-753-0291
Practice Address - Street 1:1215 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2900
Practice Address - Country:US
Practice Address - Phone:606-753-0293
Practice Address - Fax:606-753-0291
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QR1300X
FLARNP9495300363LF0000X
KY3013182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health