Provider Demographics
NPI:1912443656
Name:GREENE, CATINA N (PMHNP)
Entity Type:Individual
Prefix:
First Name:CATINA
Middle Name:N
Last Name:GREENE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6621 PRESCOTT SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-8564
Mailing Address - Country:US
Mailing Address - Phone:919-667-5888
Mailing Address - Fax:
Practice Address - Street 1:833 WAKE FOREST BUSINESS PARK STE F
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-7184
Practice Address - Country:US
Practice Address - Phone:919-230-1419
Practice Address - Fax:984-278-6610
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172218363LF0000X
NC5008364363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily