Provider Demographics
NPI:1427240480
Name:GREENE, JOAN N LEYRER (APRN CPNP)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:N LEYRER
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN CPNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 MARSETT ROAD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482
Mailing Address - Country:US
Mailing Address - Phone:802-985-5099
Mailing Address - Fax:802-985-2366
Practice Address - Street 1:10 MARSETT ROAD
Practice Address - Street 2:SUITE #2
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482
Practice Address - Country:US
Practice Address - Phone:802-985-5099
Practice Address - Fax:802-985-2366
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT1010036281363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
P31861Medicare UPIN