Provider Demographics
NPI:1770770877
Name:GREENE, PATRICIA CATHRINE (AA/RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CATHRINE
Last Name:GREENE
Suffix:
Gender:F
Credentials:AA/RN
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:CATHRINE
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:14200 SW CANARY RD
Mailing Address - Street 2:
Mailing Address - City:CROOKED RIVER RANCH
Mailing Address - State:OR
Mailing Address - Zip Code:97760-8928
Mailing Address - Country:US
Mailing Address - Phone:541-504-8399
Mailing Address - Fax:
Practice Address - Street 1:14200 SW CANARY RD.
Practice Address - Street 2:
Practice Address - City:CROOKED RIVER RANCH
Practice Address - State:OR
Practice Address - Zip Code:97760
Practice Address - Country:US
Practice Address - Phone:541-923-6288
Practice Address - Fax:541-548-7511
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse