Provider Demographics
NPI:1528531969
Name:GREENE, KAREN J (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 NH ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:NH
Mailing Address - Zip Code:03084-4212
Mailing Address - Country:US
Mailing Address - Phone:351-217-0968
Mailing Address - Fax:351-207-4358
Practice Address - Street 1:289 NH ROUTE 45
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:NH
Practice Address - Zip Code:03084-4212
Practice Address - Country:US
Practice Address - Phone:603-249-6369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2024-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA170454363LF0000X, 363LP0808X
MECNP241095363LF0000X, 363LP0808X
NH052432-23363LF0000X, 363LP0808X
MARN255864363LF0000X, 363LP0808X
VT101.0137261363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily