Provider Demographics
NPI:1740667260
Name:GREEK, JENEIL (RN, CDE)
Entity type:Individual
Prefix:
First Name:JENEIL
Middle Name:
Last Name:GREEK
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Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2400 32ND AVE S
Mailing Address - Street 2:ROUTE 2500
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5800
Mailing Address - Country:US
Mailing Address - Phone:701-234-8648
Mailing Address - Fax:701-234-8717
Practice Address - Street 1:2400 32ND AVE S
Practice Address - Street 2:ROUTE 2500
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5800
Practice Address - Country:US
Practice Address - Phone:701-234-8648
Practice Address - Fax:701-234-8717
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN223412-0163WD0400X
NDR33903163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator