Provider Demographics
NPI:1811180805
Name:GREENO, JOYCE A (LPN)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:A
Last Name:GREENO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:LARRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:918 PINNER PL
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-4270
Mailing Address - Country:US
Mailing Address - Phone:843-477-0177
Mailing Address - Fax:843-828-0338
Practice Address - Street 1:3381 PHILLIS BLVD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577
Practice Address - Country:US
Practice Address - Phone:843-477-0177
Practice Address - Fax:843-828-0338
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPR18045164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse