Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 12755 | TN |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 12755 | TN |
NPI | 1073702742 |
---|---|
Provider Name | Kelly N Greene |
First Address | Knoxville, TN 37920-1500 |
Second Address | Knoxville, TN 37920-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 05/09/2014 |