Provider Demographics
NPI:1881666758
Name:GREENBERG, MARY BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4708
Mailing Address - Country:US
Mailing Address - Phone:703-298-5770
Mailing Address - Fax:
Practice Address - Street 1:624 WARRINGTON AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20374-5022
Practice Address - Country:US
Practice Address - Phone:202-433-4050
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148184163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator