Provider Demographics
NPI:1144360421
Name:GREENE, BRENDA G (RN)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:G
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:112 KNOLLCREST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-3809
Mailing Address - Country:US
Mailing Address - Phone:423-979-4633
Mailing Address - Fax:
Practice Address - Street 1:1233 SOUTHWEST AVENUE EXTENSION
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6519
Practice Address - Country:US
Practice Address - Phone:423-979-4633
Practice Address - Fax:423-979-3268
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN037670163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health