Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 9217073 | FL |
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN9217073 | FL |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | ELIGIBLE | FL |
NPI | 1033420815 |
---|---|
Provider Name | Cassie Star Greer |
First Address | Jacksonville Beach, FL 32250-2643 |
Second Address | Jacksonville Beach, FL 32250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 21/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003466100 | (05) | FL |
47932 | UNIVERSAL HEALTHCARE (01) | FL |
710410 | WELLCARE (01) | FL |
P00929821 | RAILROAD MCR (01) | FL |
P934710 | OPTIMUM (01) | FL |
P990169 | FREEDOM HEALTH (01) | FL |
Y06YR | BCBS FL (01) | FL |