Provider Demographics
NPI:1740002518
Name:GROENE, GEENA NICOLE
Entity type:Individual
Prefix:
First Name:GEENA
Middle Name:NICOLE
Last Name:GROENE
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 1:2733 S LANCASTER DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5025
Mailing Address - Country:US
Mailing Address - Phone:402-276-1313
Mailing Address - Fax:
Practice Address - Street 1:3209 S LOUISE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-0705
Practice Address - Country:US
Practice Address - Phone:605-362-1602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist