Provider Demographics
NPI:1811988629
Name:GREENE, LOIS A (RN,C)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:A
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16835 SW 296TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-2545
Mailing Address - Country:US
Mailing Address - Phone:305-247-3920
Mailing Address - Fax:
Practice Address - Street 1:2200 S DIXIE HWY
Practice Address - Street 2:SUITE 402
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2300
Practice Address - Country:US
Practice Address - Phone:305-447-2350
Practice Address - Fax:305-447-2338
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN495252163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO143308OtherREGISTERED NURSE
FLRN495252OtherREGISTERED NURSE