Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 903631 | MS |
N | 363LA2200X | Nurse Practitioner - Adult Health | 903631 | MS |
N | 363LG0600X | Nurse Practitioner - Gerontology | 903631 | MS |
NPI | 1043841265 |
---|---|
Provider Name | Rachael Greer |
First Address | Ridgeland, MS 39158-0087 |
Second Address | Jackson, MS 39202-2002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2020 |
Last Update Date | 31/01/2020 |