Provider Demographics
NPI:1831516400
Name:GREATA, HEIDI REBEKAH
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:REBEKAH
Last Name:GREATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:194 FINLEY GOLF COURSE RD STE 104
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4401
Practice Address - Country:US
Practice Address - Phone:984-215-5151
Practice Address - Fax:984-215-5161
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33107225100000X
CO11356225100000X
NCP14800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist