Provider Demographics
NPI:1134011141
Name:GREIWE, ABIGAIL KATELYN (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:KATELYN
Last Name:GREIWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 HEALING WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5496
Mailing Address - Country:US
Mailing Address - Phone:866-337-4251
Mailing Address - Fax:
Practice Address - Street 1:2590 HEALING WAY STE 220
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5496
Practice Address - Country:US
Practice Address - Phone:866-337-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPA9120656363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program