Provider Demographics
NPI:1811722358
Name:BROWN-GREENFIELD, TOSHETA (PMHNP)
Entity type:Individual
Prefix:
First Name:TOSHETA
Middle Name:
Last Name:BROWN-GREENFIELD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:TOSHETA
Other - Middle Name:
Other - Last Name:BROWN-GREENFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1027 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-2039
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1403 E ATWATER AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-3707
Practice Address - Country:US
Practice Address - Phone:773-453-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015711A363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health