Greene, Kristina Renae

Greene, Kristina Renae is an individual health care provider with primary practice located at 980 Professional Park Dr Suite A, Clarksville TN 37040-5251. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Greene, Kristina Renae can be contacted via phone (931) 905-1001.

Contact Information

Primary practice address
980 Professional Park Dr Suite A Clarksville TN 37040-5251
Phone: (931) 905-1001
Fax: (931) 905-0410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA840 Tennessee

Profile Details

NPI number 1609879782
LBN Legal business name Greene, Kristina Renae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Apr 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609879782 NPPES
Tennessee MEDICAID 3667492
Tennessee Other P00433226

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