Provider Demographics
NPI:1942809280
Name:GREIM, PATRICIA SPANGLER (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SPANGLER
Last Name:GREIM
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GREIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4917 LEICESTER WAY
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-8643
Mailing Address - Country:US
Mailing Address - Phone:727-501-4217
Mailing Address - Fax:
Practice Address - Street 1:415 N 26TH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2895
Practice Address - Country:US
Practice Address - Phone:765-607-2001
Practice Address - Fax:765-607-2000
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28248436A163W00000X
IN71011269B363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse