Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 25ME00035001 | NJ |
NPI | 1083600068 |
---|---|
Provider Name | Mrs. Kathleen Greenhalgh |
First Address | Joint Base Lewis Mcchord, WA 98438-1103 |
Second Address | Joint Base Lewis Mcchord, WA 98438-1303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 22/03/2013 |