Provider Demographics
NPI:1972201374
Name:GREENTHANER, MICHELE R (RN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:GREENTHANER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 WILD GOOSE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-3270
Mailing Address - Country:US
Mailing Address - Phone:814-591-5170
Mailing Address - Fax:
Practice Address - Street 1:298 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-0814
Practice Address - Country:US
Practice Address - Phone:814-849-1205
Practice Address - Fax:814-849-2902
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN604818163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse