Provider Demographics
NPI:1427874080
Name:GREER, KIMBERLY SUZANNE (NP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUZANNE
Last Name:GREER
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 1:140 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-9660
Mailing Address - Country:US
Mailing Address - Phone:919-208-4903
Mailing Address - Fax:
Practice Address - Street 1:7431 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6164
Practice Address - Country:US
Practice Address - Phone:919-500-7439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCGREE-2WXM1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care