Provider Demographics
NPI:1982844452
Name:GREYEYES, ELIZABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:GREYEYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:GREYEYES-MORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:HC 70 BOX 10
Mailing Address - Street 2:
Mailing Address - City:TONALEA
Mailing Address - State:AZ
Mailing Address - Zip Code:86044-9611
Mailing Address - Country:US
Mailing Address - Phone:928-672-2623
Mailing Address - Fax:
Practice Address - Street 1:HWY 98 ROUTE 16
Practice Address - Street 2:INSCRIPTION HOUSE HEALTH CLINIC
Practice Address - City:TONALEA
Practice Address - State:AZ
Practice Address - Zip Code:86044
Practice Address - Country:US
Practice Address - Phone:928-672-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN088198163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse