Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 0101255724 | VA |
NPI | 1023200177 |
---|---|
Provider Name | Candyce Heather Greene |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 22/09/2020 |