NICOLE MARIE GREENE APRN NPI 1538830989

NPI Information

NPI: 1538830989
Provider Name: NICOLE MARIE GREENE, APRN
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: MMG LLC

PECOS Registration: Yes

Address:
450 S 900 E STE 100
SALT LAKE CITY, UT
ZIP 84102
Phone: (801) 456-2333
Get Directions

Nicole Marie Greene, APRN is a gerontology nurse practitioner in Salt Lake City, UT with 3 years of experience. Nicole Marie Greene, APRN NPI is 1538830989. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

450 S 900 E STE 100
SALT LAKE CITY, UT
ZIP 84102-983
Phone: (801) 456-2333
Fax: (801) 456-2330

The NPI 1538830989 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2021 and was last updated on 12/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	8483463-4405	UTAH	No
2	363LG0600X	Nurse Practitioner	Gerontology	8483463-4405	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8483463-4405	OTHER	UTAH	APRN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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