Provider Demographics
NPI:1952653479
Name:GREENWOOD, MARIANNE (IBCLC, RN)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:IBCLC, RN
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:KAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:209 SCURLOCK CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6101
Mailing Address - Country:US
Mailing Address - Phone:615-336-8448
Mailing Address - Fax:615-771-9256
Practice Address - Street 1:209 SCURLOCK CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6101
Practice Address - Country:US
Practice Address - Phone:615-336-8448
Practice Address - Fax:615-771-9256
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000104977163W00000X
TN108 84811174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No163W00000XNursing Service ProvidersRegistered Nurse