Provider Demographics
NPI:1902867153
Name:GREATHOUSE, GINA BARCINAS (CNP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:BARCINAS
Last Name:GREATHOUSE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 PINEVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-8790
Mailing Address - Fax:304-599-8795
Practice Address - Street 1:1322 PINEVIEW DR.
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-8790
Practice Address - Fax:304-599-8795
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN305537363L00000X
OH05415363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2400646Medicaid
OHGRNP12951Medicare ID - Type Unspecified
OH2400646Medicaid