Provider Demographics
NPI:1285955310
Name:GREENMAN, NANCY (NP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:GREENMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6917
Mailing Address - Country:US
Mailing Address - Phone:805-739-3474
Mailing Address - Fax:
Practice Address - Street 1:265 POSADA LN
Practice Address - Street 2:B
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4056
Practice Address - Country:US
Practice Address - Phone:805-434-0900
Practice Address - Fax:805-434-9260
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6629363LF0000X
CA53644363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily