Provider Demographics
NPI:1922464734
Name:GREER, DOMINIQUE (NP)
Entity Type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 GUS THOMASSON RD APT 709
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3688
Mailing Address - Country:US
Mailing Address - Phone:877-564-3627
Mailing Address - Fax:
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5172
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX837779163W00000X
TX1029220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse