Provider Demographics
NPI:1912180829
Name:GREENSPRING VILLAGE INC.
Entity Type:Organization
Organization Name:GREENSPRING VILLAGE INC.
Other - Org Name:GREENSPRING VILLAGE DIABETES EDUCATION PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN CDE
Authorized Official - Phone:703-923-3131
Mailing Address - Street 1:7410 SPRING VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-4485
Mailing Address - Country:US
Mailing Address - Phone:703-923-3131
Mailing Address - Fax:703-923-4679
Practice Address - Street 1:7410 SPRING VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-4485
Practice Address - Country:US
Practice Address - Phone:703-923-3131
Practice Address - Fax:703-923-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001095944163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty