Provider Demographics
NPI:1285401133
Name:GREENE, ELIZABETH LENE
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:LENE
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 E 56TH ST STE EE1
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1371
Mailing Address - Country:US
Mailing Address - Phone:317-760-7908
Mailing Address - Fax:
Practice Address - Street 1:5862 HARTLE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2133
Practice Address - Country:US
Practice Address - Phone:317-760-7908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist