Provider Demographics
NPI:1831595768
Name:GREENBERG, JO ALDERMAN (CRNP)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:ALDERMAN
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14999 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1074
Mailing Address - Country:US
Mailing Address - Phone:301-262-8188
Mailing Address - Fax:301-464-8233
Practice Address - Street 1:14999 HEALTH CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1074
Practice Address - Country:US
Practice Address - Phone:301-262-8188
Practice Address - Fax:301-464-8233
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR130991363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health