Provider Demographics
NPI:1780607846
Name:GREER, DEBORAH M (ARNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:GREER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 S US 301
Mailing Address - Street 2:
Mailing Address - City:SUMTERVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:33585-5141
Mailing Address - Country:US
Mailing Address - Phone:352-793-5900
Mailing Address - Fax:352-793-8050
Practice Address - Street 1:1389 S US 301
Practice Address - Street 2:
Practice Address - City:SUMTERVILLE
Practice Address - State:FL
Practice Address - Zip Code:33585-5143
Practice Address - Country:US
Practice Address - Phone:352-793-5900
Practice Address - Fax:352-793-8050
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3075592363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCF1412OtherMEDICARE RR GRP
FL269859500OtherMEDICAID GRP
77940OtherBCBS GRP
FL77940OtherBCBS
FLP00684347OtherMEDICARE RR
FL77940OtherMEDICARE GRP
FLARNP3075592OtherSTATE MEDICAL LICENSE
FLP00684347OtherRR MEDICARE
FL306343700Medicaid
FL306343700Medicaid
77940OtherBCBS GRP