Provider Demographics
NPI:1972065316
Name:GREENE, EMILY TAYLOR (BSN-RN)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:TAYLOR
Last Name:GREENE
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Gender:F
Credentials:BSN-RN
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Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:650 HIGHLAND AVE STE 110
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4304
Practice Address - Country:US
Practice Address - Phone:336-607-8523
Practice Address - Fax:336-773-0916
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
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Provider Licenses
StateLicense IDTaxonomies
NC197206364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult