Provider Demographics
NPI:1205272044
Name:GREENWAY, KIMBERLY MARIE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MARIE
Last Name:GREENWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MURLAGAN AVE APT B
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-5716
Mailing Address - Country:US
Mailing Address - Phone:650-625-8377
Mailing Address - Fax:
Practice Address - Street 1:80 MURLAGAN AVE APT B
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-5716
Practice Address - Country:US
Practice Address - Phone:650-625-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedNeonatal/Pediatrics
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula