Provider Demographics
NPI:1982064655
Name:GREER, MYKEYA
Entity Type:Individual
Prefix:
First Name:MYKEYA
Middle Name:
Last Name:GREER
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 1:5915 TRAMMELL RD
Mailing Address - Street 2:APT. N5
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1300
Mailing Address - Country:US
Mailing Address - Phone:404-542-1491
Mailing Address - Fax:
Practice Address - Street 1:1525 CLIFTON RD NE
Practice Address - Street 2:SECOND FL.
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4200
Practice Address - Country:US
Practice Address - Phone:404-727-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN089206164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse