Provider Demographics
NPI:1144697780
Name:GREENLEE, ABBY L (APRN)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:L
Last Name:GREENLEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:L
Other - Last Name:BUNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SAC CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50583-2602
Mailing Address - Country:US
Mailing Address - Phone:641-330-4706
Mailing Address - Fax:
Practice Address - Street 1:630 ONTARIO ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-1845
Practice Address - Country:US
Practice Address - Phone:712-213-2971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA124520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily