Provider Demographics
NPI:1134162779
Name:GREENE, MAUREEN THERESE (RN, CNS, ACNP)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:THERESE
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN, CNS, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 NORIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1365
Mailing Address - Country:US
Mailing Address - Phone:262-268-1328
Mailing Address - Fax:
Practice Address - Street 1:1136 NORIDGE TRL
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1365
Practice Address - Country:US
Practice Address - Phone:262-268-1328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI80002363LA2100X
WI1698-33363LA2100X
WI1698363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care